What neoplasms are in the lungs. Benign tumor in the lungs

benign tumors lungs is a broad concept that implies enough a large number of neoplasms that differ in etymology, morphological structure, place of formation, but have several main common features, these are:

• slow growth over several years;
• no metastasis or very little spread;
• absence of clinical manifestations before complications;
• the impossibility of degeneration into oncological neoplasms.

Benign lung tumors are a dense nodular formation of an oval or round shape. They develop from highly differentiated cells, which in their structure and functions are in many ways similar to healthy ones. However, the morphological structure of the neoplasm differs significantly from normal cells.

A benign tumor affects the lung much less often than a malignant one. It is mainly diagnosed in people under forty years of age, regardless of gender.

The methods and tactics of treating this pathology differ significantly from the methods of dealing with cancerous tumors of the organ.

It is difficult to clearly identify the reasons for the appearance of benign neoplasms today, since research in this direction continues. However, some pattern of this pathology is defined. The factors provoking the mutation of typical cells and their degeneration into atypical ones include:

• heredity;
• disorders at the gene level;
• viruses;
• smoking;
• bad ecology;
• aggressive UV radiation.

Classification of benign tumors

Benign respiratory tumors are categorized according to the following criteria:

• anatomical structure;
• morphological composition.

Anatomical study of the disease provides complete information about where the tumor originated and in which direction it grows. According to this principle, a lung tumor can be central and peripheral. The central neoplasm is formed from large bronchi, the peripheral one is formed from distal branches and other tissues.

Histological classification denotes tumors in accordance with the tissues from which this pathology was formed. There are four groups of pathological formations:

• epithelial;
• neuroectodermal;
• mesodermal;
• germinal, these are congenital tumors - teratoma and hamartoma.

Rare forms of benign lung tumors, these are: fibrous histiocytoma (tissues of inflammatory genesis are involved), xanthomas (connective or epithelial tissues), plasmacytoma (neoplasm arising in connection with a disorder in the function of protein metabolism), tuberculomas. Most often, the lungs are affected by an adenoma of a central location and a hamartoma with a peripheral location.

According to clinical manifestations There are three stages in the development of the disease. The key point in determining the stage of growth of the central tumor is the patency of the bronchi. So:

• the first degree is marked by partial blockage;
• the second is manifested by a violation respiratory function on the exhale;
• the third degree is a complete dysfunction of the bronchus, it excludes their breathing.

Peripheral neoplasms in the lungs are also determined by three stages of pathology progression. At the first stage, clinical symptoms do not appear, at the second they are minimal, the third stage is characterized by acute signs of tumor pressure on adjacent soft tissues and organs, there are painful sensations in the sternum and the region of the heart, difficulty breathing appears. When the tumor damages the vessels, hemoptysis and pulmonary hemorrhage occur.

Depending on the degree of tumor development, accompanying symptoms also appear. At the initial stage, when the patency of the bronchus is slightly difficult, there are practically no special symptoms. Periodically, a cough with copious sputum, sometimes with signs of blood, may disturb. General health is normal. At this stage, it is impossible to detect a tumor using an X-ray; deeper research methods are used to diagnose it.

At the second stage of tumor development, valvular stenosis of the bronchus is formed. In a peripheral tumor, inflammatory process. At this stage, anti-inflammatory therapy is used.

Complete obstruction of the bronchus is formed at the third clinical stage of a benign neoplasm. The severity of the third degree is also determined by the volume of the neoplasm and the area of ​​\u200b\u200bthe organ affected by it. This pathological condition is accompanied high temperature, asthma attacks, cough with purulent sputum and blood, there is even pulmonary bleeding. A benign lung tumor of the third degree is diagnosed using x-rays and tomography.

Diagnosis of benign neoplasms

Benign tumors are easily identified using X-ray examination and fluorography. On x-rays, the pathological seal is indicated as a dark round spot. The structure of the neoplasm has dense inclusions. The morphological structure of pathological compaction is studied by CT of the lungs. Using this procedure, the density of atypical cells and the presence of additional inclusions in them are determined. The CT method allows you to determine the nature of the formation, the presence of metastases and other details of the disease. Bronchoscopy is also prescribed, together with which a biopsy is done for a deep morphological study of the neoplasm material.

Neoplasms of the peripheral location are studied using transthoracic puncture or ultrasound-guided biopsy. Angiopulmonography examines vascular neoplasms in the lungs. If all the diagnostic methods described above do not allow obtaining complete data on the nature of the neoplasm, then thorascopy or thoracomy is used.

Treatment of lung tumors

Any pathological change in the body requires due attention from medicine and, of course, a return to normal. The same applies to tumor neoplasms, regardless of their etymology. A benign tumor also needs to be removed. The degree of complexity of surgical intervention depends on early diagnosis. Removal of a small neoplasm is less traumatic for the body. This method makes it possible to minimize risks and prevent the development of irreversible processes.

Tumors of the central location are removed using gentle resection of the bronchus, without damaging the lung tissue.

Neoplasms on a narrow base undergo a fenestrated resection of the bronchus wall, after which the lumen is sutured.

The tumor in the wide part of the base is removed by circular resection, after which an interbronchial anastomosis is applied.

In severe stages of the disease, when pathological seals in the respiratory organ grow and cause a number of complications, the doctor decides to remove its lobes. When irreversible processes begin to appear in the lungs, pneumonectomy is prescribed.

Neoplasms of the lungs, which have a peripheral location with localization in the lung tissue, are removed using exfoliation, segmental or marginal resection.

Large tumors are removed with a lobectomy.

Benign neoplasms in the lungs with a central location, which have a thin stem, are removed endoscopically. When performing this procedure, there is a risk of bleeding, as well as incomplete removal of tumor tissues.

If there is a suspicion of a malignant tumor, then the material obtained after removal is sent for histological examination. In the case of a malignant tumor, the entire spectrum is performed necessary procedures with this pathology.

Benign lung tumors respond well to treatment. After their removal, their recurrence is quite rare.

An exception is considered carcinoid. The prognosis of survival with this pathology depends on its type. If it is formed from highly differentiated cells, then the result is positive and patients get rid of this disease 100%, but with poorly differentiated cells, the five-year survival rate does not exceed 40%.

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18.05.2017

Under benign formations in the lung tissue is understood a group of tumors that differ in structure and origin.

Benign ones are detected in 10% of the total number of pathologies detected in the organ. The disease affects women and men.

A benign tumor in the lungs is distinguished by slow growth, the absence of symptoms and a destructive effect on neighboring tissues in the initial stages. That is why patients seek medical help late, being unaware of the presence of pathology.

The reason for the formation of pathologies in the lungs has not been fully elucidated, there are only assumptions in the form of heredity, long-term exposure to toxic substances, radiation, carcinogens.

The risk group includes people who often suffer from bronchitis, patients with asthma, tuberculosis, emphysema. Smoking is one of the main factors, according to doctors, which causes the development of a tumor.

Each smoker can estimate his risk of developing the disease by calculating it according to the formula - the number of cigarettes per day is multiplied by the months of the smoker's experience, and the result is divided by 20. If the resulting figure is more than 10, then the risk of discovering a lung tumor one day is high.

What are tumors

All pathological growths are classified according to the main features. By localization:

• peripheral (formed in small bronchi, grow in the depth of the tissue or on its surface) are diagnosed more often than the central ones, are detected in each of the two respiratory organs equally often;
• central (originate in large bronchi, grow either inside the bronchus or into lung tissue) are more often detected in the right lung;
• mixed.

According to the tissue from which the tumor is formed, the following are distinguished:

• those that form from the epithelium (polyp, papilloma, carcinoid, cylindroma, adenoma);
• tumors from neuroectodermal cells (schwannoma, neurofibroma);
• formations from mesodermal cells (fibroma, chondroma, leiomyoma, hemangioma, lymphangioma);
• formations from germ cells (hamartoma, teratoma).

Of the above types of growths, benign lung tumors in the form of hamartomas and adenomas are more detected.

An adenoma is formed from the epithelium, the standard dimensions are 2-3 cm. As it grows, the bronchial mucosa ulcerates and atrophies. Adenomas can degenerate into cancerous neoplasms.

Such adenomas are known: carcinoma, adenoid, as well as cylindrom and carcinoid. Approximately 86% of cases are detected carcinoid, in 10% of patients the tumor can mutate into cancer.

Hamartoma is a tumor formed from embryonic tissues (layers of fat, cartilage, glands, connective tissues, lymph accumulations, etc.). Hamartomas grow slowly and show no symptoms. They are a round tumor without a capsule, the surface is smooth. Rarely degenerate into hamartoblastoma (a pathology of a malignant nature).

Papilloma is a tumor with many outgrowths, formed from connective tissue. It develops in the tissues of large bronchi, sometimes it can block the lumen of the organ and mutate into malignancy. Sometimes several tumors of this type are detected at once - in the bronchi, trachea and larynx. In appearance, the papilloma resembles a cauliflower inflorescence, is located on the leg, also on the base, has a color from pink to red.

Fibroma is a formation up to 3 cm in size, formed from the junctional epithelium. Pathology can affect both lungs, grow to half the sternum. Neoplasms are localized centrally and peripherally, not prone to mutation.

Lipoma (aka - wen) - a tumor of adipose tissue, rarely detected in the respiratory system. It is formed in the central part of the bronchus more often than in the periphery. As the lipoma grows, it does not lose its good quality, it is distinguished by the presence of a capsule, elasticity and density. More often, a tumor of this type is diagnosed in women, it can be on the base or on the leg.

Vascular benign lung tumors (hemangioma of cavernous and capillary type, hemangiopericytoma, lymphangioma) are detected in 3% of pathological formations here. They are localized both in the center and on the periphery. They are characterized by a rounded shape, dense texture, the presence of a capsule. Tumors grow from 10 mm to 20 cm and more. Such localization is detected by hemoptysis. Hemangiopericytoma, like hemangioendothelioma - only according to some signs - benign lung tumors, because they can grow quickly and become malignant. Unlike them, hemangiomas do not quickly increase, do not affect neighboring tissues, and do not mutate.

Teratoma is a benign tumor of the lungs, consisting of a “bouquet” of tissues - sebum, cartilage and hair, sweat glands, etc. It is detected mostly in young people, it grows slowly. There are cases of suppuration of the tumor, mutation in teratoblastoma.

Neurinoma (also known as schwannoma) is a tumor of nerve tissues, which is detected in 2% of all cases of blastoma in the lung. Usually located on the periphery, it can affect 2 lungs at once. The tumor is characterized by the presence of a clear capsule, a rounded shape of the nodes. Neurinoma mutation has not been proven.

There are other benign lung tumors that are quite rare - histiocytoma, xanthoma, plasmacytoma, tuberculoma. The latter is a form of tuberculosis.

Clinical picture of a tumor in the lung

Symptoms vary from the place of growth and size of the pathological formation, the direction of its growth, hormonal dependence, and complications. As mentioned above, benign formations do not declare themselves long time, can gradually grow over the years without disturbing a person. There are three stages in the development of neoplasms:

• asymptomatic;
• initial clinical symptoms;
• severe clinical symptoms, when benign lung tumors give complications in the form of atelectasis, bleeding, abscess pneumonia, pneumosclerosis, mutation into a malignant neoplasm, metastasis.

The asymptomatic stage of a peripheral tumor, as the name implies, is characterized by the absence of symptoms. After the tumor passes into the next stages, the signs will be different. For example, large tumors can put pressure on the chest wall and diaphragm, which causes pain in the chest and heart area, shortness of breath. If the vessels have been eroded, bleeding in the lungs and hemoptysis is detected. Large tumors, squeezing the bronchi, disrupt the patency.

Benign tumors in the central part of the organ disrupt bronchial patency, causing partial stenosis, with a stronger lesion - valve stenosis, with a serious illness - occlusion. Each of the stages is characterized by its own symptoms.

With partial stenosis, the course of the disease manifests itself little, sometimes patients complain of coughing up sputum. The disease does not affect the general state of health. The tumor is not visible on the x-ray, for diagnosis it is necessary to undergo bronchoscopy, CT.

In the presence of valve stenosis (valvular), the tumor covers most of the lumen of the organ, on exhalation in the bronchus the lumen is covered, and when air is inhaled, it opens slightly. In that part of the lung where the bronchus is damaged, emphysema is detected. Due to swelling, accumulation of sputum with blood.

Symptoms are manifested in the form of cough with sputum, sometimes with hemoptysis. The patient complains of chest pain, fever, shortness of breath and weakness. If at this moment the disease is treated with anti-inflammatory drugs, pulmonary ventilation can be restored, swelling can be removed and the inflammatory process can be stopped for a while.

Bronchial occlusion reveals irreversible changes in a lung tissue fragment, its death. The severity of symptoms depends on the volume of the affected tissue. The patient is found fever, shortness of breath up to asthma attacks, weakness, coughing up sputum with pus or blood.

What are the complications of lung tumors?

The presence of a tumor in the lungs and bronchi is fraught with complications that may manifest themselves to one degree or another. Main pathological conditions listed below:

• pneumofibrosis - due to a long inflammatory process, the lung tissue loses elasticity, the affected area cannot perform a gas exchange function, connective tissue begins to grow;
• atelectasis - impaired patency of the bronchus leads to loss of ventilation due to changes in the tissue of the organ - it becomes airless;
• bronchiectasis - stretching of the bronchi due to the growth and compaction of the connective tissue next to them;
• abscessing pneumonia - a disease of an infectious nature, characterized by the formation of cavities in the tissues of the lung with pus;
• compression syndrome - pain due to compression of lung tissue;
• mutation into a malignant neoplasm, bleeding in the lungs.

Tumor diagnosis

Given the asymptomatic course of the disease in early stages, it is not surprising that tumors are detected by chance on x-ray or fluorography. On x-ray, the tumor looks like a rounded shadow with a clear contour, the structure can be homogeneous and with inclusions.

Detailed information can be obtained using CT, where it is possible to detect not only tissues of dense neoplasms, but also fatty (lipomas), as well as the presence of fluid (vascular tumors). The use of contrast enhancement on CT makes it possible to distinguish a benign tumor from peripheral cancer, etc.

Bronchoscopy as diagnostic method allows you to examine the centrally located tumor and take a fragment for a biopsy, cytological examination. In relation to peripherally located tumors, bronchoscopy is performed to detect compression of the bronchus, narrowing of the lumen, a change in the angle and displacement of the branches of the bronchial tree.

If a peripheral tumor is suspected, it is advisable to perform a transthoracic puncture or aspiration biopsy under ultrasound or x-ray control. Angiopulmonography reveals vascular neoplasms. Already at the stage of examination, the doctor may note dullness of sound during percussion, weakening of breathing, wheezing. The chest looks asymmetrical, moreover, the affected part lags behind the other when breathing.

Treatment of tumors

In general, the treatment of benign lung tumors is to remove them, regardless of the risk of degeneration into malignant neoplasms. The earlier the tumor is detected and removed, the less complications after surgery and the risk of developing an irreversible process in the lung.

Tumors localized in the central parts are removed by resection of the bronchus. If the tumor is attached with a narrow base, a complete resection is prescribed, after which the defect is sutured. If the tumor is attached with a wide base, a circular resection of the bronchus is performed and an interbronchial anastomosis is applied. If the patient has already developed complications in the form of fibrosis, abscesses, then they may prescribe the removal of 1-2 lobes of the lung, and when irreversible changes are detected, the lung is removed.

Tumors localized on the periphery are removed in several ways: enucleation, resection, and, if large, by lobectomy. Depending on a number of factors, thoracoscopy or thoracotomy is performed. If the tumor is attached to the organ with a thin leg, prescribe endoscopic surgery. The operation is minimally invasive, but side effects– there is a risk of bleeding, incomplete removal of the tumor, bronchological control is needed after the operation.

If the thoracic surgeon suspects that the tumor is malignant, an urgent histology is performed during the operation - a fragment of the tumor is examined in the laboratory. If the surgeon's suspicions are confirmed, the operation plan changes somewhat, and an operation is performed similar to the operation for lung cancer.

If a benign tumor in the lung is detected and treated in time, the long-term results will be favorable. At radical operation relapses are rare. For carcinoids, the prognosis is poor, with different types tumor 5-year survival ranges from 100 to 37.9%.

Given the above, you need to take care of your health in a timely manner and do not forget to visit doctors.

Lung cancer is the most common localization of the oncological process, characterized by a rather latent course and early appearance of metastases. The incidence of lung cancer depends on the area of ​​residence, the degree of industrialization, climatic and production conditions, gender, age, genetic predisposition and other factors.

What is lung cancer?

Lung cancer is a malignant neoplasm that develops from the glands and mucous membranes of the lung tissue and bronchi. In today's world, lung cancer occupies the top line among all oncological diseases. According to statistics, this oncology affects men eight times more often than women, and it has been noted that the older the age, the higher the incidence rate.

Development lung cancer is not the same for tumors of different histological structures. Differentiated squamous cell carcinoma is characterized by a slow course, undifferentiated cancer develops rapidly and gives extensive metastases.

The most malignant course is small cell lung cancer:

• develops secretly and quickly,
• metastasizes early.
• has a poor prognosis.

More often the tumor occurs in the right lung - in 52%, in the left lung - in 48% of cases.

The main group of patients are long-term smokers aged 50 to 80 years, this category accounts for 60-70% of all cases of lung cancer, and mortality is 70-90%.

According to some researchers, the structure of morbidity different forms This pathology depending on age is as follows:

• up to 45 - 10% of all cases;
• from 46 to 60 years - 52% of cases;
• from 61 to 75 years -38% of cases.

Until recently, lung cancer was considered a predominantly male disease. Currently, there is an increase in the incidence of women and a decrease in the age of initial detection of the disease.

Kinds

Depending on the location of the primary tumor, there are:

• central cancer. It is located in the main and lobar bronchi.
• Aeripheric. This tumor develops from the small bronchi and bronchioles.

Allocate:

1. Small cell carcinoma (less common) is a very aggressive neoplasm, as it can spread throughout the body very quickly, metastasizing to other organs. Typically, small cell cancer occurs in smokers, and by the time of diagnosis, 60% of patients have widespread metastasis.
2. Non-small cell (80-85% of cases) - has a negative prognosis, combines several forms of morphologically similar types of cancer with a similar cell structure.

Anatomical classification:

• central - affects the main, lobar and segmental bronchi;
• peripheral - damage to the epithelium of smaller bronchi, bronchioles and alveolus;
• massive (mixed).

The progression of a neoplasm goes through three stages:

• Biological - the period between the appearance of a neoplasm and the manifestation of the first symptoms.
• Asymptomatic - external signs the pathological process does not appear at all, they become noticeable only on the x-ray.
• Clinical - the period when noticeable symptoms appear in cancer, which becomes an incentive to rush to the doctor.

Causes

The main causes of lung cancer:

• smoking, including passive smoking (about 90% of all cases);
• contact with carcinogens;
• inhalation of radon and asbestos fibers;
• hereditary predisposition;
• age category over 50 years;
• influence of harmful production factors;
• radioactive exposure;
• Availability chronic diseases respiratory organs and endocrine pathologies;
• cicatricial changes in the lungs;
• viral infections;
• air pollution.

The disease develops latently for a long time. The tumor begins to form in the glands, mucosa, but metastases grow very quickly throughout the body. risk factors for the occurrence malignant neoplasm become:

• air pollution;
• smoking;
• viral infections;
• hereditary causes;
• harmful production conditions.

Please note that cancer cells that affect the lungs divide very quickly, spreading the tumor throughout the body and destroying other organs. Therefore, the important point is timely diagnosis diseases. The earlier lung cancer is detected and treated, the higher the chance of prolonging the life of the patient.

The earliest signs of lung cancer

The first symptoms of lung cancer are often not directly related to respiratory system. Patients turn to various specialists of a different profile for a long time, are examined for a long time and, accordingly, receive the wrong treatment.

Signs and symptoms of early lung cancer:

• subfebrile temperature, which is not knocked down by drugs and extremely exhausting the patient (during this period, the body undergoes internal intoxication);
• weakness and fatigue already in the morning;
• skin itching with the development of dermatitis, and, possibly, the appearance of growths on the skin (caused by the allergic action of malignant cells);
• muscle weakness and increased swelling;
• disorders of the central nervous system, in particular, dizziness (up to fainting), impaired coordination of movements or loss of sensitivity.

If these signs appear, be sure to contact a pulmonologist for diagnosis and clarification of the diagnosis.

stages

Faced with lung cancer, many do not know how to determine the stage of the disease. In oncology, when assessing the nature and extent of lung cancer, 4 stages of the development of the disease are classified.

However, the duration of any stage is purely individual for each patient. It depends on the size of the neoplasm and the presence of metastases, as well as on the rate of the course of the disease.

Allocate:

• Stage 1 - the tumor is less than 3 cm. It is located within the boundaries of a segment of the lung or one bronchus. There are no metastases. Symptoms are difficult to discern or none at all.
• 2 - tumor up to 6 cm, located within the boundaries of the segment of the lung or bronchus. Solitary metastases in individual lymph nodes. Symptoms are more pronounced, there is hemoptysis, pain, weakness, loss of appetite.
• 3 - the tumor exceeds 6 cm, penetrates into other parts of the lung or neighboring bronchi. Numerous metastases. Blood in mucopurulent sputum, shortness of breath are added to the symptoms.

How does the last 4 stage of lung cancer manifest itself?

At this stage of lung cancer, the tumor metastasizes to other organs. The five-year survival rate is 1% for small cell cancers and 2 to 15% for non-small cell cancers.

The patient has the following symptoms:

• Constant pain when breathing, which is difficult to live with.
• Chest pain
• Decrease in body weight and appetite
• Blood coagulates slowly, fractures (metastases in the bones) often occur.
• The appearance of bouts of severe coughing, often with sputum, sometimes with blood and pus.
• The appearance of severe pain in the chest, which directly indicates damage to nearby tissues, since there are no pain receptors in the lungs themselves.
• Cancer symptoms also include heavy breathing and shortness of breath if affected. cervical lymph nodes, speech difficulty is felt.

For small cell lung cancer, which develops rapidly and affects the body in a short time, only 2 stages of development are characteristic:

• limited stage, when cancer cells are localized in one lung and tissues located in close proximity.
• an extensive or extensive stage, when the tumor has metastasized to an area outside the lung and to distant organs.

Symptoms of lung cancer

Clinical manifestations of lung cancer depend on the primary location of the neoplasm. At the initial stage, most often the disease is asymptomatic. In later stages, general and specific signs of cancer may appear.

The early, first symptoms of lung cancer are non-specific and usually not alarming, and include:

• unmotivated fatigue
• loss of appetite
• slight weight loss may occur
• cough
• specific symptoms cough with "rusty" sputum, shortness of breath, hemoptysis join in later stages
• pain syndrome indicates the inclusion in the process of nearby organs and tissues

Specific symptoms of lung cancer:

• Cough - causeless, paroxysmal, debilitating, but not dependent on physical activity, sometimes with greenish sputum, which may indicate the central location of the tumor.
• Dyspnea. Shortness of breath and shortness of breath first appear in case of tension, and with the development of a tumor they disturb the patient even in a supine position.
• Pain in the chest. When the tumor process affects the pleura (the lining of the lung), where nerve fibers and ending, the patient develops excruciating pain in the chest. They are sharp and aching, disturb constantly or depend on breathing and physical exertion, but most often they are located on the side of the affected lung.
• Hemoptysis. Usually, the meeting between the doctor and the patient occurs after blood begins to come out of the mouth and nose with sputum. This symptom indicates that the tumor began to affect the vessels.

Signs of lung cancer in men

• Exhausting, frequent cough is one of the first signs of lung cancer. Subsequently, sputum appears, its color may become greenish-yellow. With physical labor or hypothermia, coughing attacks intensify.
• When breathing, whistling, shortness of breath appears;
• Pain appears in the chest area. It can be considered a sign of oncology in the presence of the first two symptoms.
• When coughing, in addition to sputum, discharge in the form of blood clots may appear.
• Attacks of apathy, increased loss of strength, increased fatigue;
• With normal nutrition, the patient loses weight sharply;
• In the absence of inflammatory processes, colds body temperature is increased;
• The voice becomes hoarse, this is due to damage to the nerve of the larynx;
• On the part of the neoplasm, pain in the shoulder may appear;
• Swallowing problems. This is due to tumor damage to the walls of the esophagus and respiratory tract;
• Muscle weakness. Patients, as a rule, do not pay attention to this symptom;
• Dizziness;
• Violation of the heart rhythm.

lung cancer in women

Signs of lung cancer in women are discomfort in the area of chest. They manifest themselves in different intensity depending on the form of the disease. Discomfort becomes especially severe if the intercostal nerves are involved in the pathological process. It is practically intractable and does not leave the patient.

Unpleasant sensations are of the following types:

• stabbing;
• cutting;
• shingles.

Along with common symptoms, there are signs of lung cancer in women:

• changes in voice timbre (hoarseness);
• enlarged lymph nodes;
• swallowing disorders;
• pain in the bones;
• frequent fractures;
• jaundice - with metastasis to the liver.

The presence of one or more signs characteristic of a single category of diseases of the respiratory organs should cause an immediate appeal to a specialist.

A person noticing the above symptoms should report them to the doctor or supplement the information he collects with the following information:

• attitudes towards smoking with pulmonary symptoms;
• the presence of cancer in blood relatives;
• a gradual increase in one of the above symptoms (it is a valuable addition, as it indicates the slow development of the disease, characteristic of oncology);
• an acute increase in symptoms against a background of chronic previous malaise, general weakness, loss of appetite and body weight is also a variant of carcinogenesis.

Diagnostics

How is lung cancer diagnosed? Up to 60% of oncological lung lesions are detected during prophylactic fluorography, on different stages development.

• Only 5-15% of patients with lung cancer are registered at stage 1
• For 2 — 20-35%
• At 3 stages -50-75%
• 4 - more than 10%

Diagnosis for suspected lung cancer includes:

• general clinical blood and urine tests;
• biochemical blood test;
• cytological studies of sputum, bronchial lavage, pleural exudate;
• assessment of physical data;
• radiography of the lungs in 2 projections, linear tomography, CT of the lungs;
• bronchoscopy (fibrobronchoscopy);
• pleural puncture (in the presence of effusion);
• diagnostic thoracotomy;
• scaling biopsy of lymph nodes.

Early diagnosis gives hope for a cure. The most reliable way in this case is an x-ray of the lungs. The diagnosis is confirmed by endoscopic bronchography. With its help, you can determine the size and location of the tumor. In addition, a cytological examination - a biopsy - is mandatory.

Treatment of lung cancer

The first thing I want to say is that treatment is carried out only by a doctor! No self-treatment! This is very important point. After all, the sooner you seek help from a specialist, the more chances for a favorable outcome of the disease.

The choice of a specific treatment strategy depends on many factors:

• Stage of the disease;
• Histological structure of carcinoma;
• The presence of concomitant pathologies;
• A combination of all the above fatcores.

There are several complementary treatments for lung cancer:

• Surgical intervention;
• Radiation therapy;
• Chemotherapy.

Surgery

Surgery is the most effective method, which is shown only in stages 1 and 2. They are divided into the following types:

• Radical - the primary focus of the tumor and regional lymph nodes are subject to removal;
• Palliative - aimed at maintaining the patient's condition.

Chemotherapy

When small cell cancer is detected, the leading method of treatment is chemotherapy, since this form of tumor is most sensitive to conservative methods of treatment. The effectiveness of chemotherapy is quite high and allows you to achieve good effect for several years.

Chemotherapy is of the following types:

• therapeutic - to reduce metastases;
• adjuvant - used as a preventive measure to prevent relapse;
• inadequate - just before surgical intervention to reduce tumors. It also helps to determine the level of cell sensitivity to drug treatment, and establish its effectiveness.

Radiation therapy

Another method of treatment is radiation therapy: it is used for non-removable lung tumors of stage 3-4, it allows to achieve good results in small cell cancer, especially in combination with chemotherapy. Standard dosage at radiation treatment is 60-70 gry.

The use of radiation therapy for lung cancer is considered as a separate method if the patient refuses chemotherapy, and resection is not possible.

Forecast

To make accurate predictions for lung cancer, perhaps, no experienced doctor will undertake. This disease can behave unpredictably, which is largely due to the variety of histological variants of the structure of tumors.

However, the cure of the patient is still possible. Usually, leads to a happy outcome using a combination of surgery and radiation therapy.

How long do people live with lung cancer?

• In the absence of treatment almost 90% of patients after the detection of the disease do not live more than 2-5 years;
• at surgical treatment 30% of patients have a chance to live more than 5 years;
• with a combination of surgery, radiation and chemotherapy the chance to live more than 5 years appears in 40% of patients.

Do not forget about prevention, these include:

• healthy lifestyle: proper nutrition and physical exercise
• rejection bad habits especially from smoking

Prevention

Prevention of lung cancer includes the following recommendations:

• Giving up bad habits, especially smoking;
• Compliance healthy lifestyle life: proper nutrition rich in vitamins and daily physical activity, walks in the fresh air.
• Treat bronchial diseases in time so that there is no transition to a chronic form.
• Airing the room, daily wet cleaning of the apartment;
• Reduce exposure to harmful chemicals and heavy metals to a minimum. During work, be sure to use protective equipment: respirators, masks.

If you have the symptoms described in this article, be sure to see a doctor for an accurate diagnosis.

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Basic information

Definition

Its edges may be smooth or uneven, but they must be distinct enough to define the contour of the defect and allow its diameter to be measured in two or more projections.

Rice. 133. Chest radiograph in frontal and lateral projections of a 40-year-old patient.
Focal blackout with clear boundaries is visible. When compared with previous radiographs, it was found that over a period of more than 10 years, the formation did not increase in size. It was considered benign and no resection was performed.

The size of the defect is also one of the criteria for determining focal lesions in the lung. The authors believe that the term "focal lesion in the lungs" should be limited to defects no larger than 4 cm. Lesions larger than 4 cm in diameter are more often malignant.

Therefore the process differential diagnosis and the examination tactics for these large formations are somewhat different than for typical small focal opacities. Of course, the adoption of a diameter of 4 cm as a criterion for assigning pathology to the group of focal formations in the lung is to a certain extent conditional.

Causes and Prevalence

Table 129

There are many reasons for this variability. For example, in studies conducted in surgical clinics, calcified defects are usually excluded, therefore, in such populations, a higher percentage of a malignant tumor is obtained compared to groups of patients from which calcified defects are not excluded.

In studies conducted in geographical areas endemic for coccidiomycosis or histoplasmosis, a higher percentage of benign changes will, of course, also be found. Age is also an important factor; in persons under 35 years of age, the probability of malignant lesions is small (1% or less), and in older patients it increases significantly. A malignant nature is more likely for large opacities than for smaller ones.

Anamnesis

Clinical symptoms of pulmonary pathology are more common in patients with a malignant origin of blackout than in patients with benign defects.

History of present illness

The presence of a chronic cough, sputum, weight loss or hemoptysis in a patient increases the likelihood of a malignant origin of the defect.

Status of individual systems

However, if a patient has a malignant process that manifests itself only as an isolated blackout in the lung, all these signs are rare. The main purpose of such a survey is usually to try to identify extrapulmonary symptoms that may indicate the presence of a primary malignant tumor in other organs or detect distant metastases of the primary lung tumor.

The presence of an extrapulmonary primary tumor can be suspected by symptoms such as a change in stool, the presence of blood in the stool or urine, the detection of a lump in the breast tissue, the appearance of discharge from the nipple.

Past illnesses

Other systemic conditions that may present with isolated opacities in the lungs include rheumatoid arthritis and chronic infections arising against the background of immunodeficiency states.

Social and occupational history, travel

It is necessary to ask the patient in detail about the conditions of his work, since some types of professional activity(asbestos production, uranium and nickel mining) are accompanied by an increased risk of malignant tumors lungs.

Taylor R.B.

Such a pathology as lung tumors is very difficult to classify and divide into groups. This is due to the fact that on the one hand they all have some similarities, but at the same time they differ from each other. The nature of the disease will depend on where the neoplasm is located, how it grows and spreads, what is the cause of its occurrence. In medicine, it is customary to divide all tumors into two broad categories:

• benign;
• malignant.

What is the difference between a benign and a malignant lung tumor?

Neoplasms in the human body appear due to a "breakdown" that occurred in the process of development and division of body cells. That is, it can be formed from absolutely any cells in which, for some reason, a developmental disorder has occurred.

As a rule, it is rather difficult to distinguish between benign and malignant tumors. But in order to do this, doctors use 2 principles:

• Features of the growth and development of neoplasms.
• Belonging to the tissue of the body from which it arose.

Benign and malignant neoplasms differ in many respects from each other. Below we will consider them.

Features of benign lung formations:

• tumor cells and tissue cells from which they were formed are completely identical in structure;
• growth has an expansive character, that is, slow (it develops as if by itself). With an increase, it pushes the tissues of the body that meet in its path;
• does not metastasize to organs and systems;
• in the case of treatment does not give relapses;
• usually does not affect the overall health of the body.

Features of malignant tumors of the lung:

• cells of a malignant neoplasm always have significant differences from the cells of the tissue from which they were formed;
• characterized by an infiltrating type of growth. That is, a cancerous neoplasm "eats" into the tissues of the organ, grows into vascular system, nerve endings. Increases in size extremely quickly;
• actively metastasize;
• after treatment for several years there are relapses;
• have an extremely negative effect on the human body.

For the convenience of their identification in the medical literature, it is accepted:

1. If the neoplasm is benign, add the suffix "oma" (adenoma, fibroma, myoma, etc.)
2. If it is of a poor quality, then they write cancer (if the tumor originated from epithelial tissue) or sarcoma (if from connective tissue).

It is extremely important to determine the nature of the tumor, since the choice and course of treatment of the patient largely depends on this.

Classification of benign lung tumors

Education of a benign nature is usually divided according to:

• anatomical structure;
• histological;
• degrees of severity;
• location.

The anatomical structure of the tumor tells us what type of tissue it was formed from and what is the vector of its growth.
By location, they are divided into:

• central;
• peripheral.

Central tumors are formed from large bronchi, peripheral - from those located far from the center.

According to the histological structure, benign formations are of four types:

1. Epithelial - formed from the cells of the surface layer. These include adenomas, papillomas.
2. Neuroectodermal - are formed from cells lining the sheath of long processes of neurons. Example: neurofibromas.
3. Mesodermal - there are their tissues of fatty and connective type. As an example: fibroids, fibroids, etc.
4. Dysembryogenetic - these are congenital benign formations that have elements of the tissue of the embryo (hamartomas and teratomas).

According to the severity of neoplasms are:

First degree: incomplete obstruction of the bronchus. A person can take both inhalation and exhalation (there are no symptoms of a tumor in the body).
Second degree: the tumor begins to function as a valve, that is, a person can inhale, but not exhale (symptoms are quite meager).
Third degree: occlusion (prolapse, exclusion) of the bronchus from the work process occurs (quite clear symptoms of the presence of a tumor in the human body are observed, as it increases in size and affects nearby organs).

Malignant tumors of the lung. Classification

Malignant neoplasms are classified according to the following criteria:

• clinical and anatomical structure;
• histological structure;
• growth rate and forecast.

According to the clinical and anatomical structure, cancer can be: central (located in large bronchi), peripheral (arises from epithelial cells smaller bronchi), mediastinal (with this form of cancer, there is a lesion lymph nodes mediastinum, despite the fact that the site of the maternal tumor in the lung is not localized), disseminated (the lungs are affected, but the location of the primary tumor has not been established).

According to the histological structure, lung cancer is:

1. Squamous.
2. Small cell cancer.
3. Glandular cancer or adenocarcinoma.
4. Large cell cancer.
5. Dimorphic or glandular squamous cell carcinoma.
6. Cancer of the bronchial glands.

When viewed from a clinical point of view, cancer will vary in rate of growth and prognosis.

It has been proven that squamous cell lung cancer and adenocarcinoma develop the slowest. And the fastest are small-celled and large-celled.

What are the symptoms of a person with a tumor in the lungs?

A benign lung tumor can manifest itself symptomatically in different ways. Symptoms will depend on the location of the tumor, its size, and sometimes on the hormonal characteristics of the patient's body. With a central benign tumor of the lung, a person first arrives in the so-called asymptomatic period. In other words, the tumor does not manifest itself outwardly, it can only be detected by chance during the examination.

At the next stage, “bells” from the formation begin, such as narrowing of the lumen in the bronchus, cough (sometimes with sputum), and shortness of breath. If the tumor has developed to a decent size (a person can only take a breath), emphysema begins. With bronchial occlusion, an inflammatory process develops, which is associated with the stagnation of biological material, which is separated from the mucous membranes of the bronchi. Occlusion provokes a rise in temperature.

If no treatment is taken, then along with the symptoms described above, there will be:

• weight loss
• weakness;
• hemoptysis;
• wheezing when listening to the patient by a doctor;
• trembling in the voice;
• decrease in performance.

Peripheral tumors (until they grow) usually do not manifest themselves in a symptomatic way. Therefore, they are most often discovered by accident. scheduled examination or at the moment when they grow and begin to interfere with breathing and cause pain in the region of the heart.

Malignant neoplasms give slightly different symptoms. In the early stages of their development, they cause:

• slight increase in body temperature;
• weakness;
• fatigue even from elementary affairs;
• general ailments.

In general, the condition is similar to that observed in SARS, with the difference that it constantly recurs and worsens.

In the following stages, a cough appears (first dry, then with purulent sputum, which may contain particles of blood). Bleeding may also begin, due to damage to the pulmonary vessels by an oncological neoplasm. When the tumor grows into the pleura and chest wall, the patient will begin to suffer from severe pain in the chest area. In the later stages of cancer, there will be exhaustion of the body, pain throughout the body (due to extensive organ metastasis) and weight loss.

Tumor Treatment Methods

A benign neoplasm should be treated only if it increases in size, interferes with life, worsens general well-being. Surgery is used for treatment. If the tumor is localized in the lumen of the bronchus, the operation is performed using an endoscope.
Still, most often they carry out a conventional abdominal operation, during which they can remove:

• only education itself;
• body of the tumor and part of the lung;
• lung segment or entire lung lobe.

The volume of the operation will depend on the size of the tumor and the results of the histological examination.

Cancer is treated with:

• surgical operation;
• chemotherapy;
• radiation or radiotherapy;
• palliative methods.

During a surgical operation, depending on its location, it can be removed:

• the entire lung lobe;
• only the body of the tumor (the so-called marginal resection);
• completely all lung - pneumonectomy;
• not only the affected lung, but also the organs adjacent to it, which could have suffered from a tumor (combined operation).

Chemotherapy is used to fight small cell cancer. Since it has a particularly detrimental effect on this type of cancer.

Radiation therapy (alone or in tandem with chemotherapy) gives good results in the third and fourth stages of cancer, when surgery is not possible due to the formation of metastases. The main disadvantage of these two methods is that they have a detrimental effect not only on cancer cells, but also on healthy human cells.

Palliative treatments are used in the last 4 stages of lung cancer, when it is impossible to cure the disease completely due to extensive metastasis. But it is possible to alleviate the suffering of the patient, support him and prolong his life at least a little bit. As part of palliative care, they use: chemotherapy, surgery, strong painkillers, radiation therapy and other methods.