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Features of a benign tumor are that the tissues of the body are not destroyed, and there are no metastases.

Features of a malignant tumor are that it grows into the tissues of the body, while metastases appear. More than 25% of situations when a local form of a malignant tumor is diagnosed, in 23% the presence of regional tumors, and in 56% - distant metastases.

The peculiarity of a metastatic tumor is that it appears in different organs, but at the same time it goes to the lungs.

This article talks about and signs of determining a lung tumor in humans. And also about the types of tumor stages and methods of treatment.

Prevalence

A lung tumor is a fairly common disease among all lung neoplasms. More than 25% of cases this species disease leads to death. More than 32% of the tumor in men is a lung tumor, in women it is 25%. The approximate age of patients is from 40-65 years.

Lung tumors are classified into several types:

1. adenocarcinoma;
2. small cell cancer
3. cancer with large cells;
4. squamous cell cancer and many other forms.

By localization, the tumor is:

1. central;
2. peripheral;
3. apical;
4. mediastinal;
5. miliary.

In the direction of growth:

1. exobronchial;
2. endobronchial;
3. peribronchial.

Also, the tumor has the properties of development without the appearance of metastases.

According to the stages of the disease, the tumor is:

• the first stage is a tumor that has a small size of the bronchi, while there is no germination of the pleura and metastases;
• the second stage - the tumor is almost the same as in the first stage, but a little larger, does not have pleural germination, but has single metastases;
• the third stage - the tumor has an even larger large size and already goes beyond the boundaries of the lung, the tumor can already grow into chest or aperture, there is a very a large number of metastases;
• - the tumor spreads very quickly to many neighboring organs, has distant metastases. Most people get sick due to the abuse of carcinogens found in tobacco smoke. Both men and women are equally at risk.

In smokers, the occurrence of lung tumors is much higher than in people who do not smoke. According to statistics, most of the patients are men. But recently the trend has changed a little, because there are a lot of women who smoke. In rare cases, a lung tumor can be hereditary.

Signs of a lung tumor

There are many theories for the development of lung cancer. The impact of nicotine on the human body contributes to the deposition of genetic abnormalities in the cells. Because of this, the process of tumor growth begins, which is almost impossible to control, moreover, the symptoms of the disease do not appear immediately. This means that the destruction of DNA begins, thereby stimulating tumor growth.

Detection of a lung tumor on an x-ray

The initial stage of a lung tumor begins to develop in the bronchi. Further, the process goes on and develops in the nearby sections of the lung. After the expiration of time, the tumor passes to other organs, gives to the liver, brain, bones and other organs.

Symptoms of a lung tumor

A lung tumor at an early stage is very difficult to detect due to its small size and the similarity of symptoms with a number of other diseases. It may be just a cough or sputum production when coughing. This period can last for many years.

Usually, doctors begin to suspect the presence of cancer in people older than 40 years. Particular attention is paid to smokers, as well as people working in hazardous industries who have at least minimal symptoms.

Complaints

In general, the most common complaint in bronchial involvement is coughing, accounting for 70% of visits and 55% of cases where people complain of hemoptysis. The cough is mostly hacking, persistent, sputum is secreted.

People with such complaints almost always have shortness of breath, very often there is chest pain, about half of the cases. In this case, most likely the tumor goes into the pleura and it increases in size. When there is a load on the recurrent nerve, wheezing appears in the voice.

When the tumor grows and compresses the lymph nodes, symptoms such as:

• weakness in upper and lower limbs;
• paresthesia if the lesion has reached the shoulder;
• Horner's syndrome;
• shortness of breath appears when the lesion has reached the phrenic nerve;
• body weight is lost;
• the appearance of itching on the skin;
• rapid development of dermatitis in the elderly.

Removal of lung tumors

A benign lung tumor, no matter what stage it is, should be removed if there are no contraindications to it. surgical treatment. Operations are performed by professional surgeons. The earlier diagnosed lung tumor and everything has been done to remove it, the less the body of a sick person suffers and the less dangerous the complications that may arise later.

Lung cancer surgery

If peripheral oncology of the lungs occurs, which is located in the tissues of the lung itself, it is removed by enucleation, i.e. in other words, by husking.

Most benign tumors are treated by thoracoscopy or thoracotomy. If the neoplasm grows on a thin stalk, it can be removed endoscopically. But this option can cause unwanted bleeding and it is imperative to re-examine the lungs and bronchi.

Diagnostics

Preparing for the operation

Chemotherapy. The process that is capable of stops their development and prevents the increase in size, while preventing their reproduction. This treatment option is used for both small cell lung cancer and non-small cell lung cancer. This process is considered the most common and is constantly used in almost all cancer hospitals.

The only drawback is that with this process, complete recovery and cure is almost impossible to achieve. But, despite everything, chemotherapy can prolong the life of a cancer patient for many years.

Good prevention of lung cancer treatment is complete absence cigarettes in a person's life.

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Symptoms and treatment of pulmonary fibroids (Read in 3 minutes)

Oncological pathology of the broncho-pulmonary system is a rather serious problem. The lungs are an organ that does not have pain receptors in its structure. Therefore, pain, as a symptom of a lesion, appears at a fairly late stage of the disease. The article discusses the main aspects of the etiology, clinic, diagnosis and treatment of peripheral lung cancer.

It then swells and infiltrates into the alveoli of the protein-rich edema fluid. Fluid and ion transport disorders, as well as increased activity of neutrophils and macrophages, lead to an increase in cytokine production. 9 Neutrophils migrate into the vesicular space, which is most likely a consequence rather than a cause of acute lung injury. The number of these cells, as well as their activation and secretion of cytokines, determine the damage to this organ.

In some cases, it is found

Activated neutrophils are isolated, in particular. oxygen free radicals, which, together with cytokines, damage alveolar epithelial cells, which in turn reduces the formation of protective surfactant 11. All these changes at the cellular level apparently affect the course of the respiratory process, causing its disorder, known by many names of lung diseases. This extremely powerful and apparently powerful organ breaks easily because it does not separate it from external factors.

Etiological factors

It is not entirely clear what exactly causes peripheral lung cancer. However, the factors that can contribute to the emergence of this disease and its rapid progression are precisely defined.

Any develops faster when smoking. The experience of systematic inhalation of nicotine directly affects the degree of threat of developing oncological pathology. In addition, the more cigarettes a patient uses per day, the more pronounced will be chronic inflammatory and degenerative changes epithelial lining respiratory tract and lungs.

The air we breathe is only slightly filtered, heated and humidified as it enters the lungs through the nose. However, it cannot stop all annoying factors. Some of them can still catch the thin layer of mucus lining the bronchi, which is extracted from the lungs using special cilia or cough reflexes - so-called. The sputum may then contain blood, oil, or pathogens 12.

Substances that override these defense mechanisms cause damage to the subtle and, in fact, subtle lungs. Although the number of illnesses that can result from their attacks is long-lasting, in principle most of them are due to similar risk factors.

The peripheral form of a cancerous lesion of the broncho-pulmonary system occurs to a greater extent not by the bronchogenic route (inhalation of carcinogenic compounds), like central cancer, but by hematogenous. For example, inhalation of asbestos or metals with a carcinogenic effect leads to the appearance. It affects the large bronchi. Peripheral lung cancer occurred more often in those individuals who had an increased concentration of the same carcinogenic compounds in their blood.

Nicotine is the best documented risk factor for lung disease. The risk of its occurrence increases with the increase in the number of cigarettes. 13. Smoking and cigars also cause more morbidity and mortality. Similarly, exposure to secondhand smoke is a major risk factor 14.

The reason for such a high impact of tobacco smoke on the development of lung diseases is that it contains highly irritating substances that lead to chronic irritation, inflammation and airway obstruction. 15. Smoking also aggravates general function lungs, exacerbates symptoms respiratory diseases and leads to cancer.

The environmental situation has a significant impact on the risks of oncopathology of the pulmonary-bronchial system. Residents of cities and megacities are prone to colonization of the respiratory tract by irritants and pollutants of various chemical composition.

Chronic inflammation of the bronchi is a significant risk factor. This applies to patients with chronic broncho-obstructive disease and bronchitis.

Causes of benign tumors

Air pollution, mainly sulfur dioxide, is associated with a significant deterioration in respiratory function. 16. This concerns primarily the long-term effects of pollution. This year, the European Society of Respiratory Congress researchers presented the latest research that shows that exposure to carbon combustion products in childhood doubles the risk of death from respiratory disease in adults.

Another study found that short-term exposure to air pollution also resulted in an immediate and immediate decrease in lung function. In: Braunwald's heart disease. . Irritation of the respiratory tract and exacerbation of symptoms of lung diseases can also be caused by dust particles and mites, gases evaporating from smokeless heating systems, volatile and semi-volatile organic compounds from chemical substances, asbestos, mold, allergens, viruses and bacteria from ventilation systems. air conditioner.

Any inflammation that occurs for a long time can become a factor in malignancy. Especially when it comes to organs lined with epithelial cells.

Heredity, closing this list, in fact, occupies far from the last place among possible causes oncological transformation of normal cells. Not only tumors of the lungs or bronchi are important, but also the cancerous process of any localization.

Genetic and congenital factors

Causes of lung disease also include genetic predisposition and congenital malformations. Some researchers have reported that the autoimmune disease depends on the development of airway obstruction. A similar relationship was observed in patients with emphysema - autoantibody levels correlated with the severity of the disease, indicating that it is partially autoimmune.

Treatment of cancers in the lungs

Significance can also be found in some coding genes, poor lung development during the fetus, frailty immune system and even gender - women are more sensitive, for example, to the effects of tobacco smoke. Of course, the main principle of prevention lung diseases is to prevent all these risk factors - especially smoking cessation, as well as proper maintenance of used heating and air conditioning appliances, ventilation of rooms and even regular cleaning to minimize the presence of dust, mites and allergens.

Symptoms of the disease

A peripheral volumetric formation, localized in any lung, exerts volumetric pressure either on the bronchi, or grows into the pleura, or other neighboring structures and organs, depending on the size. Modern oncologists distinguish several groups of clinical manifestations.

The mechanism of development of a benign lung tumor

Otherwise, we find that our respiratory system comes into contact with highly irritating substances, which leads to serious illness. Even seemingly trivial inflammation can be dangerous. Tests have also shown that certain lung conditions are more severe in people who are too low in the sun vitamin. However, they have not proven that this deficiency is a direct cause of lung disease problems.

When and how to check lung efficiency?

Australian scientists conducted further experiments on mice. The motivation to control our lungs must already be exposed to risk factors such as smoking or work that involves inhaling toxic gases or pollutants. If you experience symptoms such as cough, shortness of breath, shortness of breath or chest pain, you should think about the main function respiratory system i.e. spirometry.

The first group of symptoms are signs of intrathoracic spread of the tumor mass. However, unlike bronchogenic (central) cancer, the peripheral form of oncological disease does not manifest itself so clearly.

Cough appears with a significant size. The same goes for hemoptysis. This symptom marks the destruction of the tumor conglomerate or the germination of the bronchus with a violation of the integrity of its mucosa.

Based on the examination, the doctor determines whether there may be an obstruction, that is, an imbalance between the volume of the lungs and the volume of air flowing through the individual parts of the respiratory system. It is based on the intensive release of air from the lungs to a special device. Before its execution within 4 hours. Do not smoke or drink alcohol, and do not eat heavy meals or physical exercises. Spirometry can be done in a doctor's office.

Admittedly, it is used to determine the severity of shortness of breath and the severity of the disease 24 but may well be the first warning sign. Lung cancer is the most common malignant tumor in Poland - about 21,000 are diagnosed every year. Lung cancer is a very broad concept that refers to different types of cancer. Due to the biological characteristics and the treatment used, it is classified into: small cells and non-small cells.

Chest pain and shortness of breath are also more typical of cancers of central origin. But it is known that at large sizes, the peripheral form becomes clinically indistinguishable from bronchogenic.

Hoarseness of voice occurs when the left recurrent nerve is damaged. Peripheral cancer of the left lung is often accompanied by this striking syndrome. But the patient complains about this already with a serious size of education. Peripheral cancer of the upper lobe of the left lung is a rare finding in young patients.

At a later stage, hoarseness, cough, shortness of breath, hemoptysis, or general weakness may occur. However, in some people, the first symptoms occur only after the onset of metastases. The main risk factor for developing lung cancer is cigarette smoking - about 60 times more likely to develop multiple smokers, passive smoking, exposure to asbestos or heavy metals, inactivity, diet low in vegetables and fruits, genetic predisposition. Molecular diagnostics plays a special role in the treatment of non-small cell lung cancer.

Tuberculous lesions are more often localized there. But with age, the first and second segments become the site of localization of a peripheral malignant tumor. Peripheral cancer of the lower lobe of the left lung (as well as the right) is less common than pneumonia. This is the second most common disease in this area. Clinical Features tumors of the described localization are difficult to imagine.

Diagnosis and treatment

This makes it possible to detect mutations in the epidermal growth factor receptor in the cells of this tumor. Such changes in cells cause them to multiply rapidly, leading to rapid metastasis to other organs. The most commonly used material is cancerous lung tissue removed during surgery or tumor cells obtained by puncturing it during bronchoscopy or by puncturing it directly through the chest.

The advantage of targeted therapy for the treatment of this disease is that, unlike radiation therapy or chemotherapy, it mainly removes cells altered by cancer. If you have the opportunity to use targeted therapy, you should talk to your doctor. Ask him or her to interpret the results, explain problems you don't understand, explain what it is and what therapy looks like. Don't be afraid to ask a lot of questions. Remember, this is about your health!

Most often, peripheral cancer of the right lung develops. It's connected with anatomical features bronchial branches. Peripheral cancer of the upper lobe of the right lung is more common in older patients. Identification of radiographic changes in this area requires additional research using tomographic techniques.

How to prepare for a conversation with a doctor? The diagnosis of cancer is a shock to us. The stress associated with this makes us often unable to focus on the information provided to us by the doctor. Rational thinking replaces emotions: fear, panic. As a result, when we leave the office, we only know that we have cancer. What treatment will be used, how will it be planned, what can we expect from it?

Diagnosis of benign neoplasms

The answers to these and many other questions, even if they fell out of the mouth of a doctor, are probably not in our memory. In this situation, after cooling down, we begin to search for information “on our own”. At the same time, they are not always adequate to the specifics of our disease, and they can mislead us.

Taking into account the syntopy of the lungs, symptoms of damage to neighboring organs develop in the later stages of the disease. Dysphagia often worries patients when the esophageal wall is involved. When the tumor spreads to the heart muscle or pericardium, there are functional disorders: arrhythmias, hypertension or hypotension.

To avoid this situation, you must prepare for every visit to the doctor's office.

• Write down questions you would like to ask your doctor.
• Take a notebook, a pen, and write down the most important information.

The first step to actively participating in treatment is an open discussion with your doctor. By being ready to talk, you leave the office with the best knowledge possible about cancer and how you can best participate in the treatment process. How can I change my lifestyle to best support my targeted therapy? What changes in our lives should prepare my family?

• Do not hesitate to ask him everything that interests you and worries you.
• If you don't understand something, ask him to explain it again.
• What have my tests done and what are they waiting for?
• If not, when and how will they be implemented?
• Are Molecular Tests Painful?
• How do you do it?

Features of the apical localization of the tumor

Apical cancer does not develop as often as tumors of the above localizations. It should be noted that the apex of the lung is a favorite localization of the tuberculous process. Therefore, it is necessary to exclude this chronic infectious disease in the first place.

Cancer of the apex of the lung occurs with fairly clear symptoms that are underestimated by doctors of related specialties.

It has been well documented that in the context of lung cancer protection and prevention, high cross-consumption can protect against lung cancer, which is likely due to the presence of phytochemicals. The results show that low level omega-6 intake fatty acids and a high intake of omega-3 fatty acids may help prevent lung cancer. Pulmonary exposure to eicosapentaenoic acid has been shown to reduce the production of prostaglandins from arachidonic acid, which may lead to a reduction in cancer cell proliferation.

Regularly reduces the risk of lung cancer in women. Regular consumption protects women and men from this type of cancer. Studies have shown a negative correlation between boron intake and lung cancer in women. Preliminary results show that adequate intake of copper, zinc and iron reduces the risk of lung cancer and plays an important role in lung cancer prevention.

Yes, pain in the area shoulder joint, accompanied by atrophic changes in the muscles of the forearm, rheumatologists and therapists are regarded as a manifestation of humeroscapular periarthritis or osteoarthritis.

Apical lung cancer has a different name in the literature - Pancoast cancer. The symptom complex with this localization is also called.

It includes damage to the 1st and 2nd ribs, which is detected on the x-ray of the lungs. Horner's symptom is characteristic, which includes a triad of signs:

• miosis - constriction of the pupil;
• enophthalmos;
• ptosis (drooping) of the eyelid on the side of the lesion.

These manifestations are associated with the involvement of the sympathetic trunk in the process.

paraneoplastic syndrome

We are talking about a violation of the hormonal background and metabolic changes caused by the tumor process. Most often, the development of a clear and obvious paraneoplastic syndrome is associated with a non-small cell variant of peripheral cancer.

Typically severe muscle weakness. It may be accompanied by the appearance of a convulsive syndrome. This is due to hypomagnesemia.

Endocrine changes relate more to Cushingoid syndrome. As part of hypercortisolism, high blood pressure develops. May be bothered by darkening skin(hyperpigmentation) first in the area of ​​folds and folds, then diffuse.

Edema may also indicate paraneoplastic syndrome. But they can also be caused by the syndrome of the superior vena cava when this vessel is compressed by a tumor from the outside and subsequent thrombosis.

Metastasis

The emergence of screening foci is an inevitable part of the cancer process. Metastases of lung tumors spread in three ways:

The lymphogenous pathway is considered the main one. Regional nodes are affected first. Possible contralateral metastasis. Depending on which lymphatic collectors are affected by cancer cells, oncologists classify the disease.

Hematogenous metastases spread to various organs. The adrenal glands are often affected. At the same time, symptoms of insufficiency of the function of this organ are revealed: weakness, fall blood pressure, arrhythmias (feelings of interruptions in the work of the heart), electrolyte shifts in laboratory tests.

And the study of the skull with the help of x-rays or computed tomography reveals damage to the bones. In about a fifth of patients, metastases can be found there.

Detection of metastatic foci in the brain and liver occurs with the same frequency. Therefore, the second stage of diagnosis includes an ultrasound examination of the organs. abdominal cavity and tomography of the skull.

Diagnostic measures

The screening method for detecting a disease is fluorography. Today, the frequency of this study is once a year.

Peripheral lung cancer progresses very quickly. Therefore, doctors of any specialty should pay attention to clinical manifestations.

Usually "minor" symptoms go unnoticed. Namely, they indicate that the disease is just beginning. Unfortunately, they are very non-specific, and patients themselves rarely seek advice about their appearance. medical care. What about these symptoms?

General analysis blood can reveal the acceleration of ESR. With a significant excess normal indicators it is necessary to start the search for oncopathology. Anemia is also characteristic - a decrease in hemoglobin levels. A detailed study reveals its redistributive nature (sideroahrestic anemia).

A biochemical blood test reveals an increase in calcium levels and a decrease in magnesium concentration. The level of C-reactive protein may be increased.

Radiography is indicative in the later stages. Signs of peripheral lung cancer are not much different from the manifestations of a bronchogenic tumor in the picture, especially in the later stages.

Exist special forms peripheral lung cancer. A spherical tumor on the x-ray is visible as a round shadow. Its contours are uneven. Clinically, it is worth saying, it rarely manifests itself. This is due to the fact that spherical cancer comes from cells of the bronchi of the 4th order.

- inflammation of the lung tissue surrounding the mass formation. Against the background of treatment with antibiotics, the size of the tumor decreases markedly, but the radiologist should be alerted by the appearance of radiance around the focus of blackout. This is about inflammation. lymphatic vessels- lymphangitis.

The cavity form of peripheral lung cancer is a formation that has undergone decay in its central part. This is due to tissue ischemia. On the x-ray, it will be an annular shadow with a horizontal level of liquid. The contours are uneven.

The second stage of diagnosis is clarifying. It is necessary in order to determine the form of the disease, the prevalence of the tumor, its histological structure, the degree of differentiation, and hormonal activity.

It is necessary to identify the presence of metastases, because all this affects the prognosis and treatment tactics. In order to understand the size and degree of involvement of neighboring organs and structures, it is necessary to conduct a tomography. Mediastinoscopy, bronchoscopy, thoracoscopy are designed to assess whether the mediastinum, heart, esophagus, pleura, lymphatic collectors are affected.

Trathoracic puncture allows sampling of biological material for cytological examination. Cellular composition, differentiation of cells, histochemical features will allow us to assess the operability of the situation.

Metastases are often localized in the brain, liver. Ultrasound examination of the abdominal organs is necessary for visualization of the liver. The brain is examined using tomography.

Frequently involved adrenal glands also need to be examined. MRI is an essential technique to achieve this goal. Scanning of the bone structures of the body and x-rays reveal lesions in the bones. The bronchoscopic stage is important for differential diagnosis. They should not be neglected, but at the same time, patients should be referred for such a study according to indications.

Approaches to therapy and prognosis

There are two ways to treat lung cancer: surgical intervention and radiation therapy. The first method is not always feasible.

If there are no metastases, and the size of the tumor does not exceed 3 cm in diameter, and adjacent structures are not involved, lobectomy is indicated. It. A fairly large volume of surgery is dictated by a large number of relapses. In addition, this is required by the rules of ablastic and antiblastic, on which oncosurgery is based.

If the isolateral lymphatic collectors (on one side) of the first order are affected by metastatic foci, lobectomy may also be justified. But domestic oncosurgeons prefer the removal of the whole lung - pulmonectomy.

Germination of the tumor of the esophagus, metastases to the contralateral lymph nodes, distant organs - the brain, liver, adrenal glands - are contraindications for surgery. Also, severe concomitant pathology in the stage of decompensation will prevent surgical intervention.

In these cases, radiation therapy is used. It can be an addition to the operation. Then this treatment of peripheral cancer of one or both lungs is called complex.

Radiation exposure to the formation is advisable before surgery in order to reduce the size of the tumor. Survival is influenced by many factors. They are related both to the characteristics of the tumor process and to general condition patient:

Thus, the main problem of oncology is timely diagnosis and adequate treatment. Peripheral lung cancer, with careful attention to one's own body, can be detected in time and successfully treated.

Lung tumors can be benign and malignant, as well as metastatic.

Benign tumors do not destroy, do not infiltrate tissues and do not metastasize (for example, hamartomas).

Malignant tumors grow into the surrounding tissues and give metastases (an example is lung cancer). In 20% of cases, local forms of malignant tumors are diagnosed, in 25% there are regional, and in 55% - distant metastases.

Metastatic tumors primarily arise in other organs and metastasize to the lungs. In this article, we will look at the symptoms of a lung tumor and the main signs of a lung tumor in humans.

Symptoms of a lung tumor

Symptoms and signs of a lung tumor

Tumors of the lungs early stages are asymptomatic and are usually discovered incidentally on x-rays. preventive examinations or examination for other diseases. The asymptomatic period can last for years. A doctor should be oncologically vigilant in relation to people over 45 years of age, especially active smokers and people with occupational hazards.

Complaints with a lung tumor

With endobronchial lesions, patients complain of symptoms such as cough (in 75% of cases) and hemoptysis (57%). Cough is often hacking, constant, sometimes with scanty sputum. In such patients, to varying degrees, there are signs of bronchial obstruction, causing shortness of breath. Inspiratory dyspnea more reflects atelectasis or pleural effusion. Chest pain (in 50% of cases) is typical for tumor growth into the pleura. When the recurrent nerve is compressed, hoarseness appears.

With germination and compression by a tumor or lymph nodes with metastases nerve trunks come out on top neurological symptoms:

• weakness in the arms, paresthesia (as a result of damage to the brachial plexus);
• Horner's syndrome (miosis, narrowing palpebral fissure and enophthalmos);
• anhidrosis (as a result of damage to the cervical sympathetic nodes), which is especially typical for apical cancer (Pancost cancer);
• shortness of breath (as a result of damage to the phrenic nerve).

In malignant and especially metastasizing tumors, weight loss is characteristic, up to cachexia, as well as complaints associated with lesions of distant organs (most often the brain, skeletal bones). In some patients, the first symptom is itching, and in the elderly, there is a rapid development of ichthyosis or dermatoses.

Examination for a lung tumor

When examining a patient in the early stages of tumor development Clinical signs are not found. As the mass grows, signs appear that depend on the location of the tumor. Quite often, with lymphogenous spread, an increase in the supraclavicular lymph nodes on the left (Virchow's metastasis) is found. Expansion of collateral veins on the upper chest and neck, on the mammary gland, edema and hyperemia of the face, conjunctiva are characteristic of the syndrome of the superior vena cava. In 10-20% of cases, the examination reveals one or another manifestation of dermatosis, which disappears after removal of the tumor. late signs malignant neoplasm- weight loss, cachexia. For tumor processes, an increase in temperature is quite typical, especially evening subfebrile condition.

Signs of a lung tumor

There are several theories for the development of lung cancer. Toxic effects can lead to the accumulation of genetic abnormalities in cells (activation of dominant oncogenes and inactivation of recessive oncogenes (tumor suppression genes) as a result of mutations). This leads to uncontrolled, unorganized growth with local or distant lesions from the primary tumor. The decisive factors are DNA damage, activation of cellular oncogenes and stimulation by growth factors. Primary lung cancer usually develops from the glandular epithelium of the bronchi. As the central lung cancer grows, the bronchus becomes obstructed, which leads to its obstruction and atelectasis of the lower parts of the lung. As the tumor progresses, it grows into other organs and tissues (chest wall, pericardium, esophagus, etc.), metastasizes to the liver, brain, bones, and other organs.

Diagnosis of a lung tumor

On the side of the lesion, an increase in voice trembling can be detected.

Percussion for lung tumors

For lung tumors, a pronounced shortening of the percussion sound over the area of ​​the volume formation is characteristic. However, when the bronchus is obstructed by a tumor and the valve mechanism is formed, local emphysema may initially develop, which leads to boxed percussion sound. Subsequent atelectasis is accompanied by a shortening of the percussion sound. With mediastinal forms of lung cancer, percussion can detect signs of unilateral mediastinal expansion.

Auscultation for lung tumors

With endobronchial tumor growth, local wheezing and local weakening of breathing may appear. The appearance of moist rales along with fever, sweating and weakness may indicate the development of obstructive pneumonia.

X-ray examination of a lung tumor

big role in early detection lung tumors plays a preventive fluorographic study. It is the radiation methods of research that make it possible to detect a volumetric formation in the asymptomatic period. Suspicious symptoms: focal, spherical formations, expansion of the root and a decrease in the differentiation of its elements, expansion or displacement of the mediastinum. The first radiographic symptom in the endobronchial development of central lung cancer is hypoventilation of the area corresponding to the affected bronchus: a decrease in the transparency of a segment or lobe, convergence of the vessels and their expansion due to congestive hyperemia. On longitudinal tomograms and bronchograms, it is possible to identify the stump of the obstructed bronchus. In the peribronchial form of lung cancer, a peribronchial node associated with the bronchus wall is visible on tomograms in the plane of the root. The tuberosity of the contours of the pathological shadow is characteristic. Later, obstruction of the bronchus occurs with a picture of hypoventilation of the underlying sections.

The radiological picture of peripheral lung cancer is usually characterized by the presence of a focus localized in the upper sections (segment S3) of the right lung, the upper lobe of the left lung, or the lower lobe of the right lung. The outline of the shadow of the tumor as it progresses from clear to "radiant". Sometimes a "notch" is clearly visible - the place where the bronchus enters. In peripheral lung cancer, it is quite common to see a path connecting the focus to the root or to the parietal pleura. In about 2-10% of cases, there is a disintegration of the tumor node (cavernous form of cancer). In 3-10% of cases of peripheral cancer, radiography reveals a pleural effusion. With apical localization of lung cancer, the image shows shading in the projection of the apex, the lower border of the shadow is arched and directed downwards with a bulge. Against the background of shading, destruction of the posterior segments of the I, II, and sometimes III ribs can be detected. A manifestation of tumor dissemination in the lungs is miliary carcinomatosis.

CT scan and other types of scanning for lung tumors

High-resolution CT has become the standard method of examining a patient with tumors of the chest. CT is much more reliable than conventional radiography in characterizing the topography and structure of the shadow, but is not decisive in determining the malignancy of the process. The degree of malignancy and the histological type of the tumor is determined by biopsy.

Bronchoscopy for lung tumors

Bronchoscopy is a decisive method for examining the bronchi, which makes it possible to detect lesions up to the subsegmental bronchi, especially with endobronchial tumor growth. During bronchoscopy, samples of bronchial secretions, washings are taken, a brush or transbronchial biopsy is performed to histological examination. Fluorescent bronchoscopy allows you to see the glow of the tumor in its early stages.

Radioisotope scanning for lung tumors

Radioisotope scanning can detect metastatic lesions of the skeleton and distant metastases. However, the specificity of the method in detecting metastatic lesions of the bones of the skeleton is low.

Ultrasound for lung cancer

Ultrasound can detect pleural effusion in the early stages and parietal located tumors. Ultrasound of the liver can detect hematogenous metastases.

Study of respiratory function in lung tumors

The ventilation capacity of the lungs varies depending on the size of the tumor, the development of bronchial stenosis, atelectasis or compression of the lung tissue and is characterized by mixed disorders. With the appearance of pleural effusion, restriction prevails. Determination of the gas composition arterial blood allows you to assess the degree of hypoxemia (especially with extensive damage and advanced age).

Laboratory diagnostics lung tumors

A complete blood count is nonspecific; if pneumonia occurs, leukocytosis may develop. Cancer alertness should be caused by high ESR values in the elderly. Cytological examination sputum (detection of atypical or cancerous cells) in lung tumors is generally informative in 20% of cases. With the central localization of the tumor, the information content of the method increases to 74%.

Biopsy for lung tumor

Transthoracic and open biopsy of a tumor or altered lymph nodes using videothoracoscopy allows you to take samples of altered tissues, manipulate in the pleural cavity. This method allows you to remove metastases with a diameter of up to 3 cm, located on the periphery of the lung.

Differential Diagnosis lung tumors

On plain chest radiographs, the shadow of peripheral lung cancer should be differentiated from other formations. All spherical formations in the lungs require removal and histological examination in order to establish an accurate diagnosis.

Central lung cancer must first be differentiated from pneumonia. Violation of ventilation in tumors leads to an increase in the pulmonary pattern, which is difficult to differentiate from pneumonic infiltrate, however, bronchoscopy allows you to examine the bronchi and establish the correct diagnosis.

Tuberculoma - an encapsulated formation of a tuberculous nature looks like a focus on an x-ray. Characterized by a local shadow less than 2 cm in diameter with signs of decay; Lung cancer of this size rarely breaks down. The apparent tuberosity of the contours of tuberculoma in the picture in frontal projection may correspond to multiple or conglomerative tuberculomas when taking pictures in the lateral projection or performing CT. In favor of the tuberculous nature of the focus, foci-screenings around or below the main shadow will testify. The location of tuberculomas in the segments of the lung Si, S2, SQ is characteristic. During the decay of tuberculoma, bacteriological examination of sputum can reveal Mycobacterium tuberculosis. Tuberculomas are not characterized by progressive growth and compression symptoms. Negative tuberculin tests with tuberculoma are extremely rare.

Benign lung tumors, as a rule, are not bumpy, do not disintegrate. Unlike benign formations, with peripheral lung cancer of small size (up to 2 cm in diameter), the contours of the shadow are rarely sharp. However, in the future, as you grow (2.5-3 cm) malignant tumor takes on a clear shape. For benign tumors intoxication, hemoptysis, radiance of contours are not characteristic.

Retention cysts. Their contours are clear, without radiance and tuberosity, the pulmonary pattern is not changed. It should be remembered that the blockage of the bronchus by a cancerous tumor and the accumulation of secretions distal to the site obstructions sometimes lead to cyst formation.

The prevalence of lung cancer

Lung cancer accounts for more than 90% of all lung neoplasms and 28% of all deaths resulting from tumor diseases in humans. This is the most common malignant tumor in men (35% of all tumors) and women (30%) aged 45-70 years (in women, lung cancer is in third place in frequency after breast cancer and cervical cancer). AT last years there has been an increase in the incidence of primary lung cancer among women, with the disease in women occurring at a younger age than in men. In Russia, over the past 35 years, the number of patients with lung cancer has increased by almost 3 times. In the United States, lung tumors occur at a rate of 70 per 100,000 population, with African Americans being affected 1.5 times more frequently than whites. The most common lung neoplasms are found in the UK and Poland, where the prevalence exceeds 100 per 100,000 population, least often in Senegal and Nigeria (less than 1 per 100,000).

Classification of lung tumor

According to histological types: adenocarcinoma, small cell carcinoma, large cell carcinoma, squamous cell and other forms.

By localization: central, peripheral (localization of the tumor starting from the bronchi of the 4th order), apical, mediastinal, miliary (small millet-like foci in both lungs).

In the direction of tumor growth: exobronchial, endobronchial, peribronchial cancer. The tumor, depending on the stage, can develop without metastases, with regional and distant metastases.

According to the stages of the disease:

stage - a small limited tumor of a large bronchus with an endo- or peribronchial direction of growth or a tumor of small and smallest bronchi without germination of the pleura and metastases.

stage - the same tumor as in stage I, or larger, without germination of the pleura, in the presence of single metastases in the nearest regional lymph nodes.

stage - a tumor that has gone beyond the lung, growing into the pericardium, chest or diaphragm, in the presence of multiple metastases in regional lymph nodes.

stage - a tumor with extensive spread to neighboring organs with dissemination along the pleura, extensive regional and distant metastases.

More than 90% of lung cancer cases in men and 70% in women are associated with the carcinogenic effect of the components of tobacco smoke when smoking. In general, the risk of developing lung cancer increases 13 times with active smoking and 1.5 times with passive exposure to tobacco smoke. Occupational factors are critical in 15% of lung cancer cases in men and 5% in women. Perhaps industrial poisons and tobacco smoke act as carcinogens. In the development of some forms of lung cancer, the importance of hereditary factors is not excluded.

Pathomorphology of a lung tumor

The term "lung cancer" is used to refer to tumors arising from the epithelium of the respiratory tract (bronchi, bronchioles, alveoli). Unlike cancer, other types of tumors (mesotheliomas, lymphomas, and stromal tumors (sarcomas)) are not of epithelial origin. Four types of tumor cells form 88% of all primary lung tumors: squamous cell (epidermoid) carcinoma (29%), small cell (oat cell) carcinoma (18%), adenocarcinoma (32%, including bronchioloalveolar carcinoma) and large cell carcinoma (9%). Other tumors (undifferentiated carcinomas, carcinoids, tumors of the bronchial glands, etc.) are less common. Because the different types malignant cells respond differently to certain types of therapy, the correct histological diagnosis is necessary condition effective treatment tumors.

Lung tumors metastasize lymphogenously (to the bronchopulmonary lymph nodes, lymph nodes of the root of the lung and mediastinum) and hematogenously (distant metastases to the liver, brain, bones, lungs and other organs). In addition to lung cancer, multifocal lymphomas can also occur in the lungs. A large group is formed by metastatic tumors originating from other organs (mammary gland, colon, kidneys, thyroid gland, stomach, testicles, bones, etc.).