Abstract
The definitive diagnosis of lung cancer relies on pathological examination. Tissue samples (by biopsy), or cell samples (by washing, cytopuncture) are collected from the tumor, associated lymphadenopathy or from an accessible metastatic site. There are different methods of diagnostic access to an opacity suspect of bronchial cancer. Guidelines have been published for each of the techniques in order to maximize their diagnostic efficiency and to allow either immunohistochemical or molecular analyses that modify the therapeutic strategy. The first objective of this topic is to describe the different diagnostic methods and to suggest paths to optimize the diagnosis of broncho-pulmonary cancers. Establishing cTNM relies on a precise and rigorous evaluation.The second objective of this article is to present the modalities of NSCLC extension assessment, addressing the indications of imaging exams as well as their limitations. Clinical examination remains essential. Chest Computed-Tomography (CT) scan with iodine contrast injection is systematic. The size of the tumor, its pleural, parietal, endobronchial and direct mediastinal extension should be specified as well as the lymph node extension. 18FDG PET-CT is not indicated frontline, but is essential in patients potentially eligible for curative treatment. Brain imaging is indicated, even in asymptomatic patients. Compliance with such recommendations and proper organisation is needed to optimise patients management.1877-1203/© 2022 SPLF. Published by Elsevier Masson SAS. All rights reserved.
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