A variety of methods is used to diagnose paranasal sinus and nasal cavity cancer. They include:
- Physical exam and history: An exam of the body to check general signs of health. The head, neck, mouth and throat will be checked for signs of disease such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken.
- After a physical exam that reveals cause for suspicion of paranasal sinus and nasal cavity cancer, imaging tests may be ordered to determine the extent of spread of the tumor, if any. Standard imaging tests include:
- MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear MRI, or NMRI.
- CT scan (computed tomography scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an X-ray machine. Contrast medium (a dye injected into a vein or swallowed to help the organs or tissues show up more clearly) is generally not used when imaging the sinonasal area. This procedure is also called computed tomography computerized tomography, or computerized axial tomography.
Note: MRI and CT scans are preferred over conventional radiography (X-ray).
- Bone scan: A procedure to check if there are rapidly dividing cells such as cancer cells in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner.
After identifying the primary site or sites of the tumor, the following may be performed:
- Nasoscopy: A procedure to look inside the nose for abnormal areas. A nasoscope is inserted into the nose. A nasoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples for biopsy.
- Biopsy: The removal of suspect tissue for analysis. A pathologist views the tissue under a microscope to look for cancer cells. This test is necessary to establish three things: 1) whether the tumor is benign or malignant, 2) what type of cell the tumor originated from and 3) what grade, or level of differentiation, the tumor cells display.