Fast Five Quiz: Squamous Cell Non-Small Cell Lung Cancer

Maurie Markman, MD


September 15, 2022

Preoperative staging is used to guide proper treatment in patients with NSCLC. Guidelines recommend an initial evaluation with combined PET and CT when available. Combined CT and PET allows malignant lymph nodes to be identified with better accuracy and improves planning of biopsies. If suspicious mediastinal nodes are identified on scans, endobronchial ultrasound-guided biopsy is used to obtain a tissue diagnosis of the nodes. Multiple guidelines recommend endobronchial biopsy as the method of choice for invasive mediastinal staging, although mediastinoscopy was once regarded as the optimal choice.

A tissue biopsy is preferred to cytologic studies because it allows for greater differentiation between adenocarcinoma and squamous cell carcinoma. In addition, a tissue sample facilitates immunohistochemical and genetic analyses of the tumor. Cytologic sputum studies are suggested for high-risk patients for whom bronchoscopy or transthoracic needle aspiration might present a greater risk.

Learn more about the workup of patients with NSCLC.


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