![]() Depending on histologic type, local extension into adjacent anatomical structures, presence of metastases, and the general health of the patient, treatment options may include surgical excision, radiation therapy, chemotherapy, and possibly immunotherapy. If a primary lung cancer is detected, a metastatic workup (scans of the brain, liver, adrenals, and bones) might be indicated. Fiber optic bronchoscopy with bronchial brushings and specimens for cytology and culture.Sputum studies for cytology and cultures (standard pathogens, fungus, acid-fast bacilli),.Search for previous chest radiographs for comparison,.Initially, one or more of the following tests might be ordered: Patient care based on the physician’s assessment may include further testing or, depending on the findings, additional referrals to an oncologist and chest surgeon. Negative PPD skin test, which does not rule out tuberculosis, but makes it less likely.Absence of fever or evidence of infectious disease, and.Absence of residence in or travel to an area endemic for coccidioidomycosis (southwest United States) or histoplasmosis (Ohio/Mississippi Valley),.Sex (current or former women smokers are at higher risk).Radiographic appearance of a lesion (size and lack of calcification),. ![]() The following may increase the likelihood of the patient having a pulmonary malignancy: If a patient already has a respiratory condition, consider further testing, referral to a specialist, or both. Clinical care is based on findings from the initial clinical assessment and the health care provider’s clinical judgment.
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