Carcinoid Lung Tumor (cont.)
Carcinoid Lung Tumor Exams and Tests
There are no biochemical tests to determine the presence of a carcinoid lung
tumor or to diagnose a known lung tumor as a carcinoid lung tumor.
If your health care practitioner suspects that a patient has a
carcinoid lung tumor, he or she may be advised to undergo some blood and urine tests.
Sometimes the hormone-like substances can affect the chemistry of the blood by
and/or intestinal function and therefore alter the results of certain blood
tests. Some tests would detect some of the hormone-like substances or their
by-products produced by the carcinoid tumor.
- An abnormal finding on chest X-ray is present in about 75% of patients with
a carcinoid lung tumor.
- Findings on X-ray include either the presence of the tumor itself or
indirect evidence of its presence (for example,
obstruction caused by the
- Some carcinoid lung tumors that are small or in
locations where they are covered by other organs in the chest may not be seen on
a chest X-ray. If a patient's health care practitioner is in doubt or there is a vague
abnormality on the chest X-ray, the patient may be advised to get a
CT scan done.
- CT scna can demonstrate more details about the nodules, masses, or suspicious
changes found on chest X-ray.
- A CT scan using intravenous contrast dye also can be useful. Because
carcinoid tumors are highly vascular, they may show greater enhancement on CT
- It is useful for characterizing and
staging of the tumors.
Magnetic resonance imaging (MRI)
- MRI generally provides information similar to that of CT scan.
- MRI may be useful for differentiating small tumors from
- Octreotide scintigraphy or OctreoScan:
A small amount of octreotide (a
radioactive hormone-like drug) is injected into a
vein. The drug is taken up by
the cells of the carcinoid tumor. The health care practitioner uses a special
radioactivity-detecting camera to see where the drug accumulates. This exam
helps in the diagnosis of a carcinoid lung tumor and determining whether the
tumor has spread to other areas of the body.
- Iodine-131 meta-iodo-benzyl guanidine (MIBG) scintigraphy: MIBG is a
chemical that is taken up by the cells of the carcinoid tumor. In this exam,
radioactive iodine attached to MIBG is injected into the bloodstream. If a
carcinoid tumor is present, the scanner will detect the radioactivity and thus
help in diagnosing the tumor.
Even if a chest X-ray and/or CT scan shows a tumor,
these exams cannot confirm whether the mass is a carcinoid lung tumor, a lung
carcinoma, or a localized infection. The only way to verify the diagnosis of a
carcinoid tumor is to remove cells from the tumor and examine them under a
procedure is called biopsy.
A lung biopsy can be done in several ways:
procedure involves inserting a fiber optic
viewing tube called a bronchoscope into the
windpipe and the
airways of your lungs through the
- It allows the health care practitioner to visualize the airways of the
lungs, and in case a tumor is found, to do a biopsy.
- In most cases, the physician makes the diagnosis of
carcinoid lung tumor based on the findings from
bronchoscopy and a combination
of radiologic (for example, X-ray,
CT scan) studies.
- Transbronchial fine-needle biopsy: If the tumor is small, a fine-needle
biopsy of a carcinoid tumor may be performed through the bronchoscope. This
procedure is called transbronchial fine-needle biopsy
- Transthoracic needle biopsy: Tumors that are not accessible through
bronchoscopy and are located in the
periphery of the lung are accessed using a
long needle inserted between the ribs. CT scan images are used to guide the
needle into the tumor for taking a biopsy. This procedure is called
transthoracic needle biopsy.
- Thoracotomy (surgically opening the chest cavity): In some persons, neither
a bronchoscopic biopsy nor a transthoracic needle biopsy can provide enough
tissue to identify the type of tumor, and a
thoracotomy may be necessary to
obtain a biopsy. Usually, the tumor is completely removed during thoracotomy.
Staging is a process of finding out how localized or widespread a tumor is.
- Typical carcinoid tumors, considered the least aggressive form, most
commonly are found to be stage I tumors (localized to one area) at the time of
- More than 50% of the less common atypical carcinoid
tumors show evidence of further spread to adjacent areas or
lymph nodes at the time of diagnosis.
- The outlook for a carcinoid lung tumor depends, to a large extent, on its
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