Identify clinical and radiographical studies needed to initiate workup with a patient who has the above symptoms. Which studies are considered inconclusive, and which studies do physicians prefer as definitive ways to diagnose the disease quickly in order to initiate appropriate treatment?
Clinical evaluation involves a complete history and physical, XRays of the chest and abdomen, pulmonary function studies, and CT or MRI of the chest and abdomen. Inconclusive studies are needle biopsy of fluid from either the fluid surrounding the lung to send to pathology, or needle aspiration of fluid in abdominal cavity to retrieve fluid to send to pathology. Both of these tend to be inadequate because there is a need to determind the cell type. There can be negative or inconclusive readings which account for 85% of all fluids tested, therefore this is rarely considered as a true diagnostic evaluation. Definitive diagnosis is made by obtaining tissue samples surgically by using a thoracoscopy/laproscopy to look directly at tumor and remove an adequate amount of tissue. Open biopsies such as these are done under general anesthesia and tissue samples are taken directly to a pathologist for review.