How to identify and treat benign lung tumors. Tumor in the lung: symptoms, causes, examination, diagnosis, treatment, recovery period Neoplasms in the lungs on CT

The development of a malignant tumor in the lung, in most cases, begins from the cells of this organ, but there are also situations when malignant cells enter the lung by metastasis from another organ, which was the primary source of cancer.

Lung damage by a malignant neoplasm is the most common type of cancer that occurs in humans. In addition, it ranks first in mortality among all possible types of cancer.

More than 90% of lung tumors appear in the bronchi; they are also called bronchogenic carcinomas. In oncology, they are all classified into: squamous cell carcinoma, small cell carcinoma, large cell carcinoma and adenocarcinoma.

Another type of cancer onset is alveolar carcinoma, which appears in the alveoli (air sacs of the organ). The least common are: bronchial adenoma, chondromatous hamartoma and sarcoma.

The lungs are among the organs that most often succumb to metastasis. Metastatic lung cancer can occur against the background of advanced stages of cancer of the breast, colon, prostate, kidney, thyroid gland and many other organs.

Causes

The main cause of mutation of normal lung cells is considered to be a bad habit - smoking. According to statistics, about 80% of cancer patients diagnosed with lung cancer are smokers, and most of them are already long-term smokers. The more cigarettes a person smokes per day, the higher his chances of developing a malignant tumor in the lung.

Much less frequently, about 10-15% of all cases occur at work, in conditions of working with hazardous substances. The following are considered particularly dangerous: work in asbestos and rubber production, contact with radiation, heavy metals, ethers, work in the mining industry, etc.

It is difficult to attribute the state of the external environment to the causes of the development of lung cancer, since the air in the apartment can cause more harm than street air. In some cases, cells may acquire malignant properties due to the presence of chronic diseases or inflammation.

The presence of any symptoms in a person will depend on the type of tumor, its location and stage of progression.

The main symptom is a persistent cough, but this symptom is not specific, as it is characteristic of many diseases of the respiratory system. People should be puzzled by a cough, which over time becomes more annoying and frequent, and the sputum that is released after it is streaked with blood. If the tumor has damaged the blood vessels, there is a high risk that bleeding will begin.

The active development of a tumor and an increase in its size often occurs with the appearance of hoarseness, due to a narrowing of the airway lumen. If the tumor covers the entire lumen of the bronchus, the patient may experience collapse of the part of the organ that was associated with it; this complication is called atelectasis.

An equally complex consequence of cancer is the development of pneumonia. Pneumonia is always accompanied by severe hyperthermia, cough and pain in the chest area. If the tumor damages the pleura, the patient will constantly feel pain in the chest.

A little later, general symptoms begin to appear, which consist of: loss of appetite or its decrease, rapid weight loss, constant weakness and fatigue. Often, a malignant tumor in the lung causes fluid to accumulate around itself, which certainly leads to shortness of breath, lack of oxygen in the body and problems with the functioning of the heart.

If the growth of a malignant neoplasm causes damage to the nerve pathways that pass in the neck, the patient may experience neuralgic symptoms: ptosis of the upper eyelid, narrowing of one pupil, sunken eye, or changes in the sensitivity of one part of the face. The simultaneous manifestation of these symptoms is called Horner's syndrome in medicine. Tumors of the upper lobe of the lung can grow into the nerve pathways of the arm, which can cause pain, numbness or muscle hypotonicity.

A tumor that is located near the esophagus can grow into it over time, or it can simply grow next to it until it causes compression. Such a complication can cause difficulty swallowing, or the formation of an anastomosis between the esophagus and bronchi. With this course of the disease, after swallowing the patient experiences symptoms in the form of a severe cough, as food and water enter the lungs through the anastomosis.

Severe consequences can be caused by tumor growth in the heart, which causes symptoms such as arrhythmia, cardiomegaly, or fluid accumulation in the pericardial cavity. Often, the tumor damages blood vessels, and metastases can spread to the superior vena cava (one of the largest veins in the chest). If there is a violation of patency in it, this becomes the cause of stagnation in many veins of the body. Symptomatically, it is noticeable by swollen chest veins. The veins of the face, neck, and chest also swell and become cyanotic. The patient also develops headaches, shortness of breath, blurred vision, and constant fatigue.

When lung cancer reaches stage 3-4, metastasis to distant organs begins. Through the bloodstream or lymph flow, malignant cells spread throughout the body, affecting organs such as the liver, brain, bones and many others. Symptomatically, this begins to manifest itself as dysfunction of the organ that has been affected by metastases.

A doctor may suspect the presence of lung cancer when a person (especially if he smokes) complains of a prolonged and worsening cough, which appears in conjunction with other symptoms described above. In some cases, even without the presence of clear signs, a fluorographic image, which every person should undergo annually, can indicate lung cancer.

Chest X-ray is a good method for diagnosing tumors in the lungs, but it is difficult to see small nodes. If an area of ​​darkening is noticeable on an x-ray, this does not always mean the presence of a formation; it may be an area of ​​fibrosis that has arisen against the background of another pathology. To confirm his suspicions, the doctor may prescribe additional diagnostic procedures. Usually, the patient needs to submit materials for microscopic examination (biopsy), which can be collected using bronchoscopy. If the tumor has formed deep in the lung, the doctor can perform a puncture with a needle under CT guidance. In the most severe cases, a biopsy is taken through an operation called thoracotomy.

More modern diagnostic methods, such as CT or MRI, can detect tumors that may be missed on plain x-rays. In addition, a CT scan allows you to examine the formation more carefully, rotate it, enlarge it, and evaluate the condition of the lymph nodes. CT scanning of other organs allows us to determine the presence of metastases in them, which is also a very important point in diagnosis and further treatment.

Oncologists categorize malignant tumors based on their size and extent of spread. The stage of the pathology present will depend on these indicators, thanks to which doctors can make some predictions about a person’s future life.

Doctors remove benign bronchial tumors using surgery, since they block the bronchi and can degenerate into malignant ones. Sometimes, oncologists cannot accurately determine the type of cells in a tumor until they remove the tumor and examine it under a microscope.

Those tumors that do not extend beyond the lung (the only exception is small cell carcinoma) are amenable to surgery. But the statistics are that about 30-40% of tumors are operable, but such treatment does not guarantee a complete cure. 30-40% of patients who have had an isolated tumor with a slow growth rate removed have a good prognosis and live about 5 more years. Doctors advise such people to visit the doctor more often, as there is a chance of relapse (10-15%). This rate is much higher in those people who continue to smoke after treatment.

When choosing a treatment plan, namely the scale of the operation, doctors conduct a study of lung function in order to identify possible problems in the functioning of the organ after surgery. If the results of the study are negative, surgery is contraindicated. The volume of the part of the lung to be removed is selected by surgeons during the operation; it can range from a small segment to the entire lung (right or left).

In some cases, a tumor that has metastasized from another organ is removed first in the main focus, and then in the lung itself. Such an operation is performed infrequently, since doctors’ forecasts for life within 5 years do not exceed 10%.

There are many contraindications to surgery, this could include heart pathology, chronic lung diseases, the presence of many distant metastases, etc. In such cases, doctors prescribe radiation to the patient.

Radiation therapy has a negative effect on malignant cells, destroying them and reducing the rate of division. In inoperable, advanced forms of lung cancer, it can alleviate the general condition of the patient, relieving bone pain, obstruction in the superior vena cava, and much more. The negative side of radiation is the risk of developing an inflammatory process in healthy tissues (radiation pneumonia).

The use of chemotherapy to treat lung cancer often does not have the desired effect, except for small cell cancer. Due to the fact that small cell cancer almost always spreads to distant parts of the body, surgery for its treatment is ineffective, but chemotherapy is excellent. For about 3 out of 10 patients, this therapy helps prolong life.

A large number of cancer patients report serious deterioration in their general condition, regardless of whether they undergo therapy or not. Some patients whose lung cancer has already reached stages 3-4 have such forms of shortness of breath and pain that they cannot tolerate them without the use of narcotic drugs. In moderate doses, narcotic drugs can significantly help a sick person alleviate his condition.

It is difficult to say exactly how long people diagnosed with lung cancer live, but doctors can give estimated figures based on statistics on five-year survival rates among patients. No less important points are: the general condition of the patient, age, presence of concomitant pathologies and type of cancer.

How long do they live at stage 1?

If the initial stage was diagnosed on time and the patient was prescribed the necessary treatment, the chances of survival within five years are 60-70%.

How long do people live at stage 2?

During this stage, the tumor is already of decent size, and the first metastases may appear. The survival rate is exactly 40-55%.

How long do people live at stage 3?

The tumor is already more than 7 centimeters in diameter, the pleura and lymph nodes are being affected. Chances of life 20-25%;

How long do people live at stage 4?

The pathology has reached its most extreme stage of development (terminal stage). Metastases have spread to many organs, and a lot of fluid accumulates around the heart and in the lungs themselves. This stage has the most disappointing prognosis of 2-12%.

Video on the topic

Most people, upon hearing the diagnosis of a “tumor”, without going into details of the disease, immediately panic. At the same time, a huge number of pathological formations developing in the human body are benign in origin and are not an illness associated with a risk to life.

The lungs are the main organ responsible for proper breathing and are characterized by a truly unique structure and structural cellular content.

The human lungs are a paired organ adjacent to the heart area on both sides. Reliably protected from injury and mechanical damage by the rib cage. They are penetrated by a huge number of bronchial branches and alveolar processes at the ends.

They supply blood vessels with oxygen, and due to their large branching, they enable uninterrupted gas exchange.

At the same time, the anatomical structure of each lobe of the organ is somewhat different from one another, and its right part is larger in size than the left.

What is a non-cancerous tumor?

Benign tumor formation in tissues is a pathology caused by disruption of the processes of cell division, growth and regeneration. At the same time, in a certain fragment of an organ, their structure changes qualitatively, forming an anomaly atypical for the body, characterized by certain symptoms.

A characteristic feature of this type of pathology is their slow development, in which the compaction can remain small in size and almost completely latent for quite a long time. Very often it can be completely healed. It never metastasizes and does not affect other systems and parts of the body.

Since formations do not cause much trouble to their “owner”, it is quite difficult to detect their presence. As a rule, diseases are diagnosed accidentally.

In this video, the doctor clearly explains the difference between benign tumors and malignant ones:

Classification

The form of benign formation is a capacious concept and is therefore classified according to its manifestation, cellular structure, ability to grow and stage of the disease. Regardless of whether the tumor belongs to any of the types described below, it can develop in both the right and left lungs.

By localization

Depending on the place of formation of the seal, the following forms are distinguished:

• central– this includes tumor anomalies that develop in the cells of the inner surface of the walls of the main bronchus. Moreover, they grow both inside this part of the organ and in the tissues surrounding it;
• peripheral– this includes pathologies that developed from the distal parts of the small bronchi or fragments of lung tissue. The most common form of compaction.

By distance to the organ

Neoplasms of benign origin are classified according to the distance from the location from the surface of the organ itself. They can be:

• superficial– develop on the epithelial surface of the lung;
• deep– concentrated deep inside the organ. They are also called intrapulmonary.

By structure

Within the framework of this criterion, the disease is distinguished into four types:

• mesodermal tumor These are mainly fibromas and lipomas. Such compactions are 2-3 cm in size and come from connective cells. They are distinguished by a rather dense consistency; in advanced stages they reach a gigantic size. Sealed in a capsule;

epithelial– these are papillomas, adenomas. They account for approximately half of all diagnosed benign lung tumors. They are concentrated in the cells of the glandular mucous tissues of the tracheal membrane and bronchi.

In the vast majority of cases they differ in central localization. They do not grow deep inside, increasing mainly in height;

• neuroectodermal– neurofibromas, neurinomas. It originates in Schwann cells located in the myelin sheath. It does not grow to large sizes - at most, the size of a walnut. This can sometimes cause a cough, accompanied by pain when trying to inhale;
• dysembryogenetic– hamartomas, teratomas. It develops in the fatty and cartilaginous tissues of the organ. The thinnest vessels, lymphatic flows and muscle fibers can pass through it. Differs in peripheral location. The size of the compaction varies from 3-4 cm to 10-12. The surface is smooth, less often slightly bumpy.

Symptoms

Primary symptoms of the disease are almost always absent. Only as the compaction grows, when the stage of the pathology is already quite advanced, can the first signs of the presence of a benign lung tumor appear:

• wet cough– haunts about 80% of patients with this diagnosis. Very similar to the symptoms of bronchitis - low, expectorant, after which relief comes for a short time. For many people, it lasts almost constantly and is no less annoying than the cough of a heavy smoker;
• pneumonia– it can be triggered by any viral infection occurring against the background of an existing pathology. The treatment is worse than usual. The course of antibiotic therapy is longer;
• increase in body temperature– against the background of developing internal inflammation, as well as blockage of the bronchial lumen, which even with a favorable course of the disease is caused by a tumor, body temperature can remain slightly above normal almost constantly;
• coughing up blood clots– occurs when the formation is large enough and puts pressure on neighboring tissues, damaging blood vessels;
• pressing pain in the sternum– accompanied by increased intensity at the time of inhalation, coughing, and expectoration of sputum. Occurs due to the presence of a foreign body inside the organ, which negatively affects respiratory function;
• difficulty breathing– characterized by constant shortness of breath, weakness of the respiratory tract, sometimes dizziness, and in particularly difficult situations, involuntary fainting;
• general weakness– provoked by a decrease in appetite, which is typical in the presence of any formations, regardless of their nature, as well as by the body’s constant struggle with pathology;
• deterioration of health– as the disease progresses, the protective forces drop sharply, the person more often suffers from concomitant ailments, quickly gets tired and loses interest in an active lifestyle.

Causes

Oncologists put forward several theories about the main cause of the disease. However, there is still no common point of view on this issue. Surely, only factors have been identified that, under favorable conditions, can cause benign pathology of the organ:

• genetic predisposition to cancer manifestations;
• excessive concentration of carcinogens in the human body;
• constant interaction due to the nature of work with poisonous and toxic compounds, the vapors of which can enter the respiratory system;
• tendency to colds and viral infections;
• asthma;
• active form of tuberculosis;
• nicotine addiction.

Complications

A disease that is ignored for a long time is fraught with the following complications:

• pneumofibrosis– a decrease in the elastic properties of the connective tissue of the lung, which developed as a result of increased formation;
• atelectasis– blockage of the bronchus, and as a result, lack of ventilation of the organ, which is quite dangerous;
• bronchiectasis– stretching of connective tissues;
• compartment syndrome;
• bleeding;
• mutation of a tumor into cancer pathology.

Detection

There are the following main ways to detect the disease:

• blood analysis– determines the general condition of the body, the level of its resistance to disease;
• bronchoscopy– gives a visual assessment of the pathology, and takes material for subsequent biopsy, which determines the nature of the origin of the affected cells;
• cytology– shows indirect signs of the course of the disease – the degree of compression of the tumor, the level of the lumen, deformation of the bronchial branches;
• x-ray– determines the outline of the seal, its size and location;
• CT– gives a qualitative assessment of the structural content of the anomaly, determines the amount of liquid contained in it.

Therapy

Almost all forms of the disease are subject to surgical treatment; the earlier the surgical intervention is performed, the more gentle the recovery process will be.

Amputation of the seal is carried out in the following ways:

• lobectomy– cutting off a lobar part of an organ, while its functionality is preserved. It is carried out both on one lobe and on two, if the compaction is multiple;
• resection– “economical” cutting off of diseased tissue fragments with subsequent suturing of healthy fragments encircling it;
• enucleation– is removed by exfoliating the tumor from the capsular membrane. Indicated when the size of the seal is no more than 2 cm in diameter.

It is possible to control the dynamics of the disease, as well as its therapy through traditional medicine. The method is not so effective and works only at the stage of the formation of compaction, when growth processes are still inactive.

Have a positive effect on the body:

• carrot juice;
• dairy products;
• tomatoes.

Their regular use inhibits the growth process of the anomaly and contributes to its slight reduction. A balanced diet restores immunity, which is the most important condition for preserving the benign nature of the pathology and preventing its degeneration into cancer, which poses a life-threatening threat to the patient.

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Basic information

Definition

A focal formation in the lung is a radiographically determined single defect of a round shape in the projection of the pulmonary fields (Fig. 133).

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

Rice. 133. X-ray of the chest in frontal and lateral projections of a 40-year-old patient.
Focal darkening 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 resection was not performed.

The surrounding lung parenchyma should appear relatively normal. Calcifications and small cavities are possible inside the defect. If most of the defect is occupied by a cavity, then a recalcified cyst or thin-walled cavity should be assumed; these nosological units are not advisable to include in the type of pathology being discussed.

The size of the defect is also one of the criteria for determining focal formations in the lung. The authors believe that the term “focal formation in the lungs” should be limited to a defect size of no more than 4 cm. Formations with a diameter of more than 4 cm are more often of a malignant nature.

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

Causes and prevalence

The causes of focal opacities in the lungs can be different, but in principle they can be divided into two main groups: benign and malignant (Table 129). Among benign causes, the most common are granulomas caused by tuberculosis, coccidioidomycosis, and histoplasmosis.

Table 129. Causes of focal formations in the lungs

Among the malignant causes of darkening, the most common are bronchogenic cancers and metastases of tumors of the kidneys, colon, and breast. According to various authors, the percentage of dark spots that later turn out to be malignant ranges from 20 to 40.

There are many reasons for this variability. For example, studies conducted in surgical clinics typically exclude calcified defects, and therefore, such populations have a higher percentage of malignancy compared with groups of patients from which calcified defects are not excluded.

Studies conducted in geographic areas where coccidioidomycosis or histoplasmosis are endemic will also, of course, show a higher percentage of benign changes. Age is also an important factor; in persons under 35 years of age, the likelihood of malignant lesions is low (1% or less), and in older patients it increases significantly. A malignant nature is more likely for large opacities than for smaller ones.

Anamnesis

Most patients with focal formations in the lungs do not have any clinical symptoms. However, by carefully questioning the patient, you can obtain some information that can help in diagnosis.

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

History of present illness

It is important to collect information regarding recent upper respiratory tract infections, influenza and influenza-like conditions, and pneumonia, since sometimes pneumococcal infiltrates are round in shape.

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

Status of individual systems

With the help of correctly asked questions, it is possible to identify the presence of non-metastatic paraneoplastic syndromes in a patient. These syndromes include: clubbing fingers with hypertrophic pulmonary osteoarthropathy, ectopic hormone secretion, migratory thrombophlebitis and a number of neurological disorders.

However, if a patient’s malignant process manifests itself only as an isolated darkening in the lung, all these signs are rare. The main purpose of such an interview 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 from a primary lung tumor.

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

Past illnesses

The possible etiology of focal opacities in the lungs can be reasonably suspected if the patient previously had malignant tumors of any organs or the presence of a granulomatous infection (tuberculosis or fungal) was confirmed.

Other systemic diseases that may be accompanied by the appearance of isolated opacities in the lungs include rheumatoid arthritis and chronic infections that occur against the background of immunodeficiency states.

Social and professional history, travel

A history of long-term smoking significantly increases the likelihood of a malignant nature of focal changes in the lungs. Alcoholism is accompanied by an increased likelihood of tuberculosis. Information about the patient’s residence or travel to certain geographic areas (endemic zones for fungal infections) makes it possible to suspect the patient of any of the common (coccidioidomycosis, histoplasmosis) or rare (echinococcosis, dirofilariasis) diseases that lead to the formation of opacities in the lungs.

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

Taylor R.B.

Not all tumors that form in the lungs indicate cancer; approximately 10% of them do not contain malignant cells and belong to a general group called “benign lung tumors.” All of their tumors differ in origin, location, histological structure, and clinical features, but they are united by very slow growth and the absence of metastasis.

General information about benign neoplasms

The development of a benign formation occurs from cells that are similar in structure to healthy ones. It is formed as a result of the onset of abnormal tissue growth, over the course of many years it may not change in size or increase very slightly, often does not show any signs and does not cause discomfort to the patient until complications begin.

Neoplasms of this localization are nodular seals of oval or round shape; they can be single or multiple and localized in any part of the organ. The tumor is surrounded by healthy tissues; over time, those that create the boundary atrophy, forming a kind of pseudocapsule.

The appearance of any compaction in an organ requires a detailed study to determine the degree of malignancy. The chance of getting a positive answer to the question: “Can a tumor in the lungs be benign” is much higher in the patient:

• who leads a healthy lifestyle;
• I do not smoke;
• by age – under 40 years old;
• undergoes a medical examination in a timely manner, during which the compaction is detected in a timely manner (at the initial stage of its development).

The reasons for the formation of benign tumors in the lungs have not been sufficiently studied, but in many cases they develop against the background of infectious and inflammatory processes (for example: pneumonia, tuberculosis, fungal infections, sarcoidosis, Wegener's granulomatosis), and abscess formation.

Attention! Benign neoplasms of this localization are included in ICD 10, the group is marked with code D14.3.

Classifications of pathological neoplasms

In medical practice, they adhere to the classification of benign lung tumors, based on the localization and formation of the tumor compaction. According to this principle, there are three main types:

• central. These include tumor formations formed from the walls of the main bronchi. Their growth can occur both inside the bronchus and into adjacent surrounding tissues;
• peripheral. These include formations formed from the distal small bronchi or segments of lung tissue. According to their location, they can be superficial and deep (intrapulmonary). This species is more common than the central ones;
• mixed.

Regardless of the type, tumor lumps can appear in both the left and right lungs. Some tumors are congenital, others develop during life under the influence of external factors. Neoplasms in the organ can form from epithelial tissue, mesoderm, neuroectoderm.

Overview of the most common and well-known types

This group includes many types of neoplasms, including the most common ones, which are often heard among the population and are described in any abstract on benign lung tumors.

1. Adenoma.

Adenomas account for more than half of all benign tumors localized in the organ. They are formed by the cells of the mucous glands of the bronchial membrane, tracheal ducts and large respiratory tracts.

In 90% of them, they are characterized by central localization. Adenomas are mainly formed in the wall of the bronchus, grow into the lumen and thickness, sometimes extrabronchially, but do not invade the mucosa. In most cases, the form of such adenomas is polyp-like; tuberous and lobular ones are considered more rare. Their structures can be clearly seen in the photos of benign lung tumors presented on the Internet. The neoplasm is always covered with its own mucosa, occasionally covered with erosion. There are also fragile adenomas containing a mass of curd consistency inside.

Neoplasms of peripheral localization (of which about 10%) have a different structure: they are capsular, with a dense and elastic internal consistency. They are uniform in cross section, granular, yellowish-gray in color.

According to histological structure, all adenomas are usually divided into four types:

• carcinoids;
• cylindromas;
• combined (combining the characteristics of carcinoids and cylinder);
• mucoepidermoid.

Carcinoids are the most common type, accounting for about 85% of adenomas. This type of neoplasm is considered a slow-growing, potentially malignant tumor, which is distinguished by its ability to secrete hormonally active substances. Consequently, there is a risk of malignancy, which ultimately occurs in 5-10% of cases. A carcinoid that has become malignant metastasizes through the lymphatic system or bloodstream, thus reaching the liver, kidneys, and brain.

Other types of adenomas also carry the risk of cells degenerating into malignant ones, but they are very rare. Moreover, all neoplasms of the type considered respond well to treatment and practically do not recur.

1. Hamartoma.

Among the most common is hamartoma, a benign lung tumor formed from several tissues (organ lining, fatty and cartilaginous), including elements of germinal tissues. Thin-walled vessels, lymphoid cells, and smooth muscle fibers can also be observed in its composition. In most cases, it has a peripheral localization; pathological compactions are most often located in the anterior segments of the organ, on the surface or in the thickness of the lung.

Externally, a hamartoma has a round shape with a diameter of up to 3 cm, it can grow up to 12, but there are rare cases of larger tumors being detected. The surface is smooth, sometimes with small bumps. The internal consistency is dense. The neoplasm is gray-yellow in color, has clear boundaries, and does not contain a capsule.

Hamartomas grow very slowly, and can compress the vessels of the organ without growing them; they have a negligible tendency to malignancy.

1. Fibroma.

Fibromas are tumors formed by connective and fibrous tissue. In the lungs they are detected, according to various sources, from 1 to 7% of cases, but predominantly in males. Externally, the formation looks like a dense whitish node about 2.5-3 cm in diameter, with a smooth surface and clear boundaries that separate it from healthy tissue. Less common are reddish fibromas or those connected to the organ by a stalk. In most cases, compactions are peripheral, but they can also be central. Tumor formations of this type grow slowly, there is no evidence of their tendency to malignancy yet, but they can reach too large a size, which will seriously affect the function of the organ.

1. Papilloma.

Another well-known but rare case for this location is papilloma. It forms only in large bronchi, grows exclusively into the lumen of the organ, and is characterized by a tendency to malignancy.

Externally, papillomas have a papillary shape, covered with epithelium, the surface can be lobular or granular, in most cases with a soft-elastic consistency. The color can vary from pinkish to dark red.

Signs of a benign neoplasm

Symptoms of a benign lung tumor will depend on its size and location. Small lumps most often do not develop; they do not cause discomfort for a long time and do not worsen the general well-being of the patient.

Over time, a seemingly harmless benign tumor in the lung can lead to:

• cough with phlegm;
• pneumonia;
• increase in temperature;
• coughing up blood;
• pain in the chest;
• narrowing of the lumen and difficulty breathing;
• weaknesses;
• general deterioration of health.

What treatment is provided?

Absolutely all patients who have been diagnosed with a neoplasm are interested in the question: what to do if a benign lung tumor is discovered and is surgery performed? Unfortunately, antiviral therapy does not have an effect, so doctors still recommend surgery. But modern methods and equipment of clinics make it possible to perform removal as safely as possible for the patient, without consequences or complications. The operations are performed through small incisions, which shortens the recovery period and improves the aesthetic component.

The only exceptions are inoperable patients for whom surgery is not recommended due to other health problems. They are indicated for dynamic observation and radiographic control.

Is there a need for complex invasive surgery? Yes, but it depends on the size of the pathological compaction and the development of concomitant diseases and complications. Therefore, the doctor chooses the treatment option on a strictly individual basis, guided by the results of the patient’s examination.

Carefully! There is not a single proof of the effectiveness of treating such pathologies with folk remedies. Do not forget that everything, even benign formations, carries a potential danger in the form of malignancy, that is, a change in character to malignant is possible, and this cancer is a deadly disease!

Lung cancer is the most common localization of the oncological process, characterized by a rather latent course and the early appearance of metastases. The incidence rate 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 membrane of the lung tissue and bronchi. In the modern world, lung cancer ranks top among all cancer diseases. According to statistics, this oncology affects men eight times more often than women, and it was noted that the older the age, the much higher the incidence rate.

The development of lung cancer is different for tumors of different histological structures. Differentiated squamous cell carcinoma is characterized by a slow course; undifferentiated carcinoma develops quickly and gives extensive metastases.

Small cell lung cancer has the most malignant course:

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

Most 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, men aged 50 to 80 years; this category accounts for 60-70% of all cases of lung cancer, and the mortality rate is 70-90%.

According to some researchers, the structure of incidence of various forms of 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 old – 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.
• Aeripheral. This tumor develops from small bronchi and bronchioles.

Highlight:

1. Small cell cancer (less common) is a very aggressive neoplasm, as it can very quickly spread throughout the body, metastasizing to other organs. As a rule, 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 alveloli;
• massive (mixed).

The progression of the tumor goes through three stages:

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

Causes

Main causes of lung cancer:

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

The disease develops covertly for a long time. The tumor begins to form in the glands and mucous membrane, but metastases grow very quickly throughout the body. Risk factors for the occurrence of malignant neoplasms are:

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

Please note: Cancer cells that attack the lungs divide very quickly, spreading the tumor throughout the body and destroying other organs. Therefore, timely diagnosis of the disease is important. The earlier lung cancer is detected and its treatment is started, the higher the chance of extending the patient’s life.

The very first signs of lung cancer

The first symptoms of lung cancer often have no direct connection with the respiratory system. Patients spend a long time turning to different specialists of different profiles, are examined for a long time and, accordingly, receive the wrong treatment.

Signs and symptoms of early stage lung cancer:

• low-grade fever, which is not controlled by medications and is extremely exhausting for the patient (during this period the body is exposed to internal intoxication);
• weakness and fatigue already in the first half of the day;
• itching of the skin with the development of dermatitis, and possibly the appearance of growths on the skin (caused by the allergic effect of malignant cells);
• muscle weakness and increased swelling;
• Central nervous system disorders, in particular dizziness (even fainting), impaired coordination of movements or loss of sensitivity.

If these signs appear, be sure to contact a pulmonologist to undergo diagnostics and clarify the diagnosis.

stages

When faced with lung cancer, many people 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 disease development are classified.

However, the duration of any stage is purely individual for each patient. This depends on the size of the tumor and the presence of metastases, as well as on the speed of the disease.

Highlight:

• Stage 1 – tumor less than 3 cm. Located within the boundaries of a segment of the lung or one bronchus. There are no metastases. Symptoms are subtle or non-existent.
• 2 – tumor up to 6 cm, located within the boundaries of a segment of the lung or bronchus. Single metastases in individual lymph nodes. Symptoms are more pronounced: hemoptysis, pain, weakness, and loss of appetite appear.
• 3 – the tumor exceeds 6 cm, penetrates into other parts of the lung or neighboring bronchi. Numerous metastases. Symptoms include blood in mucopurulent sputum and shortness of breath.

How does the last stage 4 of lung cancer manifest?

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

The patient develops the following symptoms:

• Constant pain when breathing, which is difficult to live with.
• Chest pain
• Decreased body weight and appetite
• Blood clots slowly, and fractures (bone metastases) often occur.
• The appearance of severe coughing attacks, 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.
• Symptoms of cancer also include heavy breathing and shortness of breath, if the cervical lymph nodes are affected, difficulty speaking is felt.

Small cell lung cancer, which develops rapidly and affects the body in a short time, is characterized by only 2 stages of development:

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

Symptoms of lung cancer

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

Early, first symptoms of lung cancer are not specific and usually do not cause alarm, these include:

• unmotivated fatigue
• loss of appetite
• slight weight loss may occur
• cough
• specific symptoms: cough with “rusty” sputum, shortness of breath, hemoptysis that occurs in later stages
• pain syndrome indicates the involvement of nearby organs and tissues in the process

Specific symptoms of lung cancer:

• Cough is causeless, paroxysmal, debilitating, but not dependent on physical activity, sometimes with greenish sputum, which may indicate the central location of the tumor.
• Dyspnea. Lack of air and shortness of breath first appear in case of exertion, and as the tumor develops, they bother the patient even in a supine position.
• Pain in the chest. When the tumor process affects the pleura (the lining of the lung), where the nerve fibers and endings are located, the patient develops excruciating pain in the chest. They can be sharp and aching, constantly bother you or depend on breathing and physical stress, but most often they are located on the side of the affected lung.
• Hemoptysis. Typically, a 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 has begun to affect the blood vessels.

Stages of lung cancer	Symptoms
1	dry cough; weakness; loss of appetite; malaise; temperature increase; headache.
2	The disease manifests itself: hemoptysis; wheezing when breathing; weight loss; elevated temperature; increased cough; chest pain; weakness.
3	Signs of cancer appear: increased wet cough; blood, pus in sputum; difficulty breathing; dyspnea; problems with swallowing; hemoptysis; sudden weight loss; epilepsy, speech impairment, in the small cell form; intense pain.
4	The symptoms are getting worse; this is the last stage of cancer.

Signs of lung cancer in men

• A debilitating, frequent cough is one of the first signs of lung cancer. Subsequently, sputum appears, its color may become greenish-yellow. During physical labor or hypothermia, coughing attacks intensify.
• When breathing, whistling and shortness of breath appear;
• Pain syndrome appears in the chest area. It can be considered a sign of cancer if the first two symptoms are present.
• When you cough, 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 or colds, body temperature is elevated;
• The voice becomes hoarse, this is due to damage to the laryngeal nerve;
• The neoplasm may cause pain in the shoulder;
• 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;
• Heart rhythm disturbance.

Lung cancer in women

Important signs of lung cancer in women are discomfort in the chest area. They manifest themselves in varying intensity depending on the form of the disease. The discomfort becomes especially strong if the intercostal nerves are involved in the pathological process. It is practically unstoppable and does not leave the patient.

Unpleasant sensations are of the following types:

• piercing;
• cutting;
• encircling.

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

• changes in voice timbre (hoarseness);
• enlarged lymph nodes;
• swallowing dysfunction;
• 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 respiratory diseases should be the reason for immediate contact with a specialist.

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

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

Diagnostics

How is lung cancer determined? Up to 60% of lung cancer lesions are detected during preventive fluorography, at different stages of development.

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

Diagnosis for suspected lung cancer includes:

• general clinical blood and urine tests;
• biochemical blood test;
• cytological studies of sputum, bronchial washings, pleural exudate;
• assessment of physical data;
• X-ray of the lungs in 2 projections, linear tomography, CT scan of the lungs;
• bronchoscopy (fiber bronchoscopy);
• pleural puncture (if there is effusion);
• diagnostic thoracotomy;
• Prescale biopsy of lymph nodes.

Early diagnosis offers hope for cure. The most reliable way in this case is an x-ray of the lungs. The diagnosis is clarified using endoscopic bronchography. It can be used to determine the size and location of the tumor. In addition, a cytological examination (biopsy) is required.

Lung cancer treatment

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

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

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

There are several complementary treatments for lung cancer:

• Surgical intervention;
• Radiation therapy;
• Chemotherapy.

Surgery

Surgical intervention is the most effective method, which is indicated only at stages 1 and 2. The following types are divided:

• Radical – the primary tumor focus 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 treatment method is chemotherapy, since this form of tumor is the most sensitive to conservative treatment methods. The effectiveness of chemotherapy is quite high and can achieve good results for several years.

Chemotherapy is of the following types:

• therapeutic – to reduce metastases;
• adjuvant – used for prophylactic purposes to prevent relapse;
• inadequate – immediately before surgery to reduce tumors. It also helps to identify the level of sensitivity of cells to drug treatment and establish its effectiveness.

Radiation therapy

Another treatment method is radiation therapy: it is used for incurable lung tumors of stage 3-4; it allows achieving good results in small cell cancer, especially in combination with chemotherapy. The standard dosage for radiation treatment is 60-70 gray.

The use of radiation therapy for lung cancer is considered as a separate method if the patient refuses chemotherapy and resection is impossible.

Forecast

Perhaps no experienced doctor will undertake to make accurate predictions for lung cancer. This disease can behave in unpredictable ways, which is largely explained by the variety of histological variations in the structure of tumors.

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

How long do people live with lung cancer?

• Without treatment almost 90% of patients do not survive more than 2–5 years after diagnosis of the disease;
• during surgical treatment 30% of patients have a chance to live more than 5 years;
• with a combination of surgery, radiation and chemotherapy Another 40% of patients have a chance to live more than 5 years.

Don’t forget about prevention, which includes:

• healthy lifestyle: proper nutrition and exercise
• giving up bad habits, especially smoking

Prevention

Prevention of lung cancer includes the following recommendations:

• Quitting bad habits, primarily smoking;
• Maintaining a healthy lifestyle: proper nutrition rich in vitamins and daily physical activity, walks in the fresh air.
• Treat bronchial diseases in a timely manner so that they do not become chronic.
• Ventilation of the premises, daily wet cleaning of the apartment;
• It is necessary to reduce contact with harmful chemicals and heavy metals to a minimum. During work, be sure to use protective equipment: respirators, masks.

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