General Aspects

Abstract

Diagnostic pulmonary pathology is usually the last step in a series of various diagnostic procedures. Except in an emergency the clinical diagnostic procedure begins with a detailed history of the disease, a thorough physical examination and chest radiographs. Computed tomography (CT) follows in the majority of cases, especially where there are solid, circumscribed masses, subpleural densities, or mediastinal lymphomas. Sonography confirms or rules out pleural effusions. Detailed lung function analyses are necessary for calculating the preoperative risk and may contribute to the diagnostic and therapeutic process. Perfusion and ventilation scintigraphy gives information about topographic disturbances of lung function and is normally performed prior to invasive diagnostic procedures. Magnetic resonance imaging (MRI) is especially useful for distinguishing mediastinal lymphomas from major blood vessels. Filtered tomography of the hilar region or of the whole chest may detect additional lesions as small as 2 mm in diameter.