[Medical Q&A] Some lung cancer patients have undergone lung CT scans. Why do they also need bronchoscopy?

Planner: Chinese Medical Association

Reviewer: Zhou Xin, Chief Physician, First People's Hospital, Shanghai Jiao Tong University School of Medicine

For lung cancer patients, lung CT scans can provide detailed lung images, but cannot provide a clear pathological diagnosis. Bronchoscopy has unique advantages in this regard.

During the examination, the doctor will insert an endoscope through the nasal cavity or oral cavity, through the pharynx and larynx, and into the trachea and bronchi. The front end of the endoscope is equipped with a light source and a camera, which can transmit images of the inside of the trachea to the monitor for real-time observation by the doctor, helping the doctor to determine the exact location of the tumor and accurately obtain cell samples. After pathological examination of the sample, the type of lung cancer can be determined, so that targeted treatment measures such as surgical treatment and conservative treatment can be taken for the patient. In general, the diameter of the endoscope is 3 to 6 mm, so it is more suitable for patients with central lung cancer (the tumor is located near the main bronchi, lobar bronchi and other large airways). If the CT scan shows that the tumor is located in the periphery of the lungs (non-central lung cancer) and surgical treatment is determined, bronchoscopy is not very meaningful at this time. Of course, if necessary, local treatments such as laser ablation and electrocoagulation can be performed during the examination. Anesthesia of the throat is required before the examination, so avoid eating for 2 hours after the examination. Discomfort or pain may occur in the throat after the examination, which usually resolves on its own within a few days. If there is mild bleeding, it usually stops on its own.