Initially, the physician obtains a patient's medical history, including any tobacco use, smoke exposure and family history of cancer. The physician will conduct a physical examination of the patient’s body for signs of disease. Specific focus is placed on lymph node enlargement, masses on the body and in the abdomen (e.g., enlargement of the liver) and unusual chest and breathing signs. Other tests used in diagnosis of non-small cell lung cancer (NSCLC) may include:

• Blood and urine tests. These tests are taken to determine chemical or hormonal abnormalities that may suggest cancer.
  
  
• Sputum cytology. A sample of sputum or phlegm is taken and undergoes microscopic examination. This test on occasion has lead to early detection of carcinoma.
  

Most of the diagnostic imaging tests for NSCLC are the same as those for small cell lung cancer (SCLC). They include CAT scans,    MRI (magnetic resonance imaging), x-rays and others.  Other tests include:

• Bronchoscopy. A fiber optic flexible tube is placed through the mouth, down the trachea (windpipe) and into the breathing passages where the walls of the bronchi can be visualized. Biopsies of lung tissues can be performed during this procedure.
  
  
• Mediastinoscopy. After the patient undergoes general anesthesia, a lighted instrument is placed through an incision in the neck above the sternum and used to view the inside of the chest cavity. The mediastinum (center of the chest) and nearby lymph nodes are viewed for tumors. A biopsy may also be taken.
  
  
• Anterior mediastinotomy. Similar to mediastinoscopy but it is done through a srugical incision in the chest.
  
  
• Thoracentesis. After the skin is numbed, a needle is inserted between the ribs to remove fluid around the lungs, if present,  to observe for cancer cells.
  
  
• Biopsy. A sample of tissue is removed from the suspicious area and analyzed by microscopic examination by a pathologist. Whenever possible, a biopsy is performed with endoscopic procedures.