DIAGNOSIS

A. Nasopharyngeal Carcinoma
Describes options for diagnosing this type of
Cancer :

• The type of cancer suspected

• Signs and symptoms
• Age and medical condition
• The results of earlier medical tests
The following tests may be used to diagnose NPC:

Physical examination and blood test. A blood test

to check for antibodies against the EBV virus may be
done at the same time. See the Risk Factors and
Prevention section for more information about EBV.

Endoscopy. The person may be sedated as the tube

is inserted through the mouth or nose to examine
the head and neck areas. Sedation is giving
medication to become more relaxed, calm, or
sleepy. When an endoscopy is done to look into the
nasopharynx, it is called a nasopharyngoscopy.
Biopsy. The type of biopsy performed will depend
on the location of the cancer.

X-ray. An x-ray is a way to create a picture of the

structures inside of the body, using a small amount
of radiation. Sometimes, a barium swallow may be
required before having an x-ray. The barium coats
the mouth and throat to enhance the image on the
x-ray. An x-ray of the skull and chest may be needed
to learn more about the extent of NPC.
Computed tomography (CT or CAT) scan. A CT scan
can be used to measure the tumor’s size.
Sometimes, a special dye called a contrast medium
is given before the scan to provide better detail on
the image.

Magnetic resonance imaging (MRI). An MRI is

more sensitive than a CT scan in detecting a tumor
of the nasopharynx and any possible spread to
nearby tissues or lymph nodes. MRI can be used to
measure a tumor’s size
 B. Lung Carcinoma
Chest x-ray
is often the initial imaging test. It may show
clearly defined abnormalities, such as a single
mass or multifocal masses or a solitary
pulmonary nodule, an enlarged hilum,
widened mediastinum, tracheobronchial
narrowing, atelectasis, nonresolving
parenchymal infiltrates, cavitary lesions, or
unexplained pleural thickening or effusion
Cytology
 The method used to obtain cells or tissue
for confirmation depends on the accessibility of
tissue and the location of lesions.

 Sputum or pleural fluid cytology is the

least invasive method. In patients with productive
cough, sputum specimens obtained on awakening
may contain high concentrations of malignant cells,
but yield for this method is < 50% overall.

 Pleural fluid is another convenient source

of cells; a malignant effusion is a poor prognostic
sign and indicates advanced stage disease.
Percutaneous biopsy is the next least invasive
procedure. It is more useful for metastatic sites

 (eg, supraclavicular or other peripheral

lymph nodes, pleura, liver, adrenals) than for lung
lesions.

 Risks include a 20 to 25% chance of

pneumothorax (primarily in patients with significant
emphysema) and the risk of obtaining a false-
negative result.

.
Bronchoscopy is the procedure most often used for
diagnosing lung cancer.

 In theory, the procedure of choice for

obtaining tissue is the one that is least invasive;
however, in practice, bronchoscopy is often done in
addition to or instead of less invasive procedures
because diagnostic yields are greater and because
bronchoscopy is important for staging
 C. Mediastinal Tumours
• Chest x-ray
• Computed tomography (CT) scan of the chest or
CT-guided needle biopsy
• Magnetic resonance imaging (MRI) of the chest
• Mediastinoscopy with biopsy (Performed under
general anesthesia, this examination of the chest
cavity uses a lighted tube inserted through a
small incision under the chest bone; a sample of
tissue is taken to determine if cancer is present.
Mediastinoscopy with biopsy allows doctors to
accurately diagnose 80 to 90% of mediastinal
tumors, and 95 to 100% of anterior mediastinal
tumors.)
DIFFERENTIAL DIAGNOSIS
 A. Nasopharyngeal Carcinoma
• Polip nasal
• Limfom Non-Hodgkin
• TB Nasophaynx
• TB neck limph node
• Angiofibroma Sarcoma
 B. Lung Carcinoma
• Pulmonary Tuberculosis
• Mediastinal Tumours
• Pulmonary Abcess
• Tuberculoma
• Pneumonia
 C. Mediastinal Tumours
• Lung Carsinoma
• Neurogen Tumours
• Cyst Bronkhogen, pericardial or enterogen
• Germ cell tumours
• Thoracic Aortic Aneurysm