Differential diagnosis and investigations of Bronchogenic carcinoma

This are the investigations needed to reach diagnosis in a case of bronchogenic carcinoma , and its differential diagnosis (DDx) .

Bronchogenic-carcinoma-x-rayInvestigations

X- ray shows :
- Coin shadow               - Cavity, collapse.
- Mediastinum mass       - Diaphragmatic paralysis
- Effusion                       - Rib erosion

CT scan chest
Sputum examination (cytology) for malignant cells, this may be helpful in patients who are not fit for bronchoscopy.
Bronchoscopy : biopsy and bronchial brush samples, also it can assess the proximity of central tumours to the main carina.
L. N biopsy from scalene pad of fat .
Mediastinoscopy ( for local extension)
Pleural biopsy in patients with pleural effusion.

• If bronchoscopy fails to obtain a cytological diagnosis, percutaneous needle biopsy under CT guidance may be helpful in patients with peripheral tumours.
• Laboratory investigations for paramaliganant syndrome .

Differential diagnosis of bronchogenic carcinoma

Lung abscess.
Pneumonia
• T.B.
• Pulmonary infarction
• Other causes of pleural effusion & mediastinal syndrome .
Important articles to read : 
• Manifestations of Bronchogenic carcinoma (clinical picture)

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