Tests for carcinoid tumour of the lung
This page tells you about tests you may have for carcinoid of the lung.
A chest X-ray looks for anything that is abnormal. Chest X-rays don’t give a very detailed picture. If you have a clear X-ray but your doctor still thinks that you may have a carcinoid tumour, you will probably need a scan as well.
Bronchoscopy and biopsy
A bronchoscopy test looks at the inside of your airways through a narrow flexible tube that your doctor passes down your throat. Your doctor may take samples of tissue (biopsies). You have this test under local or general anaesthetic.
If the tumour is in a part of your lung that is hard to reach, a surgeon may do an operation to take a sample of the tumour.
Blood and urine tests
Carcinoid tumours can make hormones and other substances that show up in your blood or urine. You will have blood and urine tests to look for these.
You can view and print the quick guides for all the pages in the diagnosing carcinoid section.
A chest X-ray looks for anything that is abnormal. Some lung carcinoids are picked up when having a chest X-ray for something else.
Chest X-rays don’t give a very detailed picture. If you have a clear X-ray but your doctor still thinks that you may have a carcinoid you will probably need a scan as well.
CT scanners take X-ray pictures from different angles to form a detailed picture of the inside of your body. The doctor uses the scan to look at the tumour, and see whether it has spread anywhere else in the body.
You may have an injection of a special dye (called contrast) into a vein in your arm during the scan. This makes it easier for your doctor to see the blood vessels.
An MRI scan uses magnetism rather than X-rays to build up a picture. MRI scans are especially good at showing up soft tissue.
For this scan you need to change into a special gown and remove jewellery and any other metal. During the scan you need to lie very still. You may find it very noisy and will have earplugs or headphones to help block out the noise.
An octreoscan is a type of radioactive scan. This test is also called somatostatin receptor scintigraphy.
Octreotide is a substance that carcinoid cells may take up (absorb). Doctors attach a radioactive substance to the octreotide, which then shows up on the scan. Areas where the radioactivity has collected may show where a carcinoid tumour is in the body and if it has spread.
You have the octreotide as an injection into a vein in your arm. About 4 hours later you have a scan using a special type of scanner. You have another scan the next day, and possibly the day after that.
The dose of radiation is low. But after having the radioactive injection and for a couple of days afterwards, you should avoid long periods of close contact with pregnant women and children. The staff at the hospital will advise you about this.
A bronchoscopy examines the inside of your airways through a narrow flexible tube that your doctor passes down your throat. Your doctor looks down the tube at the lining of your airway and may take samples of tissue (biopsies). They may also use a brush to take samples of the tumour cells.
You can have this test under local or general anaesthetic. This means you are awake and the doctor numbs your airways. Or they give you drugs to make you unconscious. If you have a general anaesthetic, you may need to stay in hospital overnight.
If the tumour is in a part of the lung that is hard to reach, your surgeon may do an operation (thoracotomy) to take a sample of the tumour. Or they may use a CT scan to guide a needle into the tumour (CT guided biopsy).
If your biopsy doesn’t find a carcinoid but your doctor thinks you are likely to have one, you may have an endobronchial ultrasound. You generally have medicines to make you drowsy (sedation), rather than a general anaesthetic. So you can usually have this test as an outpatient.
After your sedation has worked, your doctor passes a flexible tube called an endoscope into your airway, in the same way as having a bronchoscopy. The endoscope creates ultrasound pictures of the area around the airways. If the doctor sees a tumour, they can take biopsies.
Carcinoids can release high amounts of serotonin. The body breaks down serotonin to a substance called 5-HIAA. We get rid of 5-HIAA in our urine, so a raised amount in the urine can be a sign of carcinoid. Your doctor or nurse will ask you to collect all your urine over 24 hours to measure the amount of 5-HIAA.
While you are collecting urine for this test, and for a few days beforehand, you should avoid eating foods which are rich in serotonin, such as bananas, tomatoes, avocados, walnuts, pineapple and kiwi fruit.
Some medicines can also affect the level of 5-HIAA in your urine. So you may need to stop taking them for a few days before your test. Your doctor or nurse will advise you about this.
If you have carcinoid syndrome you have a higher risk of heart disease. You will have an echocardiogram at diagnosis and continue to have regular check ups.
If you have any changes in your heart, you will see a doctor who specialises in heart problems. You may need to take tablets to help. Some people may need to have surgery to the heart valves.
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