Tumor in the lungs symptoms in adults. benign lung tumor

A lung tumor does not consist only of neoplasms in the lung tissue. In this disease, the appearance of cells that differ significantly in structure from healthy ones occurs in the lungs, bronchial tree and pleura. In pulmonology, diagnostics divides formations in the lungs into malignant and benign, depending on the degree of differentiation. The first, in turn, are primary, arising directly in the organs of the respiratory system, or secondary, which are metastases from other organs.

The most common disease among all cancers is lung cancer, it also leads to the highest percentage of deaths - a fatal outcome occurs in thirty percent of cases, which is more than with cancer of any other organ. The number of tumors that are detected in the pulmonary system and are malignant in nature is 90 percent of all neoplasms. Approximately eight times more likely to suffer from malignant pathologies of the tissues of the lung and bronchi of the male person.

Unlike similar diseases of other organs, the causes of diseases of the pulmonary system, which have a tumor form, are known. The main reason why a tumor in the lungs can appear is heredity. Most often, neoplasms in the lungs are formed under the influence of carcinogens contained in cigarette smoke, while both active and passive smokers fall into the risk group. Factors leading to pathological cell division are divided into:

1. Exogenous - smoking, exposure to radiation, living in an ecologically polluted area, exposure to chemicals on the body;
2. Endogenous - age-related changes, frequent bronchitis and pneumonia, bronchial asthma.

People at risk should be examined every six months, the rest of the fluorography should be performed once a year.

Classification

Basically, malignant tumors in the lungs appear from the bronchial tree, while the neoplasm can be localized in the peripheral or central part of the organ. Based on localization, there are different forms of malignant tumors. With a peripheral location, the development of a round tumor, cancer of the apex of the lung or pneumonia-like cancer is possible. With central localization, branching, peribronchial nodular or endobronchial cancer may occur. Metastatic tumors can be brain, bone, mediastral and others. According to the histological structure, doctors distinguish the following types of cancer:

1. Squamous - from the cells of the epidermis;
2. - from glandular tissues;
3. Small cell and large cell - undifferentiated tumors;
4. Mixed - a neoplasm of several types of tissue;
5. - develops from connective tissue;
6. Lymphoma of the lungs - from the lymphoid formations of the bronchopulmonary system.

Lung tumors of a benign type by location are:

1. Peripheral - the most common type, arising from the small bronchi. Such formations can grow both on the surface of the tissue and inside it;
2. Central - formed from the tissue of large bronchi, tend to grow into the tissue of the lung itself or into the middle of the bronchus, mainly diagnosed in the right organ;
3. Mixed.

According to the type of tissue from which the neoplasm is formed, it can be:

• epithelial - for example, an adenoma or a polyp;
• mesodermal - leiomyoma, fibroma;
• neuroectodermal - neurofibroma, neurinoma;
• germinal (congenital type) - teratoma and.

Focal formations of the lungs in the form of adenomas and hamartomas occur more often than others and are diagnosed in seventy percent of benign lung tumors.

• Adenoma - is formed from epithelial cells and in ninety percent of situations is localized in the center of large bronchi, causing a violation of air permeability. Basically, the size of adenomas is about two or three centimeters. During growth, the neoplasm leads to atrophy and ulceration of the bronchial mucosa. In rare cases, a neoplasm of this type is malignant.
• Hamartoma - the formation is of embryonic origin, consists of embryonic elements, such as cartilage, fat accumulations, muscle fibers, thin-walled vessels. Most often it has localization in the anterior segment along the periphery of the lung. A tumor grows in the tissue of an organ or on its surface. The formation is round in shape, has a smooth surface, there is no capsule, there is a restriction from neighboring tissues. As a rule, the formation grows slowly and asymptomatically, occasionally malignancy occurs in hamartoblastoma.
• Papilloma is another name for fibroepithelioma. It is formed from the stroma of fibrous tissue, has multiple outgrowths in the form of papillae. It affects large bronchi, grows inside them, often leading to complete blockage of the lumen. There are frequent cases of simultaneous occurrence with neoplasms of the trachea or larynx. Often malignant, the surface is lobed, similar in appearance to a raspberry or cauliflower inflorescence. The tumor may be basal or pedunculated. The formation is pink or dark red, soft-elastic in structure.
• Fibroma of the lungs - grows from fibrous tissue and can grow in size such that it takes up half the volume of the chest. Localization is central if large bronchi are affected or peripheral if other departments are affected. The node has a good density, as well as a capsule, the surface is pale or reddish. Such formations never degenerate into cancer.
• Lipoma - a tumor is extremely rare and consists of fat cells that are separated from each other by partitions of fibrous tissue, mainly detected by chance during an x-ray. Most often localized in the main or lobar bronchi, less often in the peripheral section. The abdomino-mediastral type of neoplasm, which comes from the mediastinum, is a common one. Education is characterized by slow growth and is not malignant. The tumors are round in shape, densely elastic in texture, and have a distinct yellow capsule.
• Leiomyoma - a rare type, arises from smooth muscle fibers in the walls of the bronchi or their vessels. Women are more susceptible to the disease. They are localized in the peripheral or central lobe, outwardly resemble a polyp on a wide base or stalk, or it looks like multiple small nodes. It grows very slowly, but over the years of an asymptomatic course, it can grow very large. It has a well-defined capsule and soft texture.
• Teratoma is a dermoid or embryonic cyst (abnormal accumulation of germ cells). Disembryonic dense tumor with a clear capsule, inside which you can find tissues of various types (sebaceous masses, bones, teeth, hair, sweat glands, nails, cartilaginous tissues, etc.). It is diagnosed in youth, grows slowly, sometimes suppurates or malignizes into teratoblastoma. It is localized exclusively in the periphery, mainly at the top of the left lung. If the tumor is large, it may rupture, causing an abscess or pleural empyema.
• Vascular tumors - lung hemangioma, lymphangioma, are diagnosed in three percent of cases. They are localized in the center or in the periphery, rounded in shape, densely elastic in consistency with a connecting capsule. Their color can be pink or dark red, the diameter varies from two millimeters to twenty or more centimeters. In the presence of a tumor in the large bronchi, there is a release of blood streaks with sputum.
• Neurogenic tumors - occur in two percent of cases, contain nerve tissue. Localization is more often in the periphery, sometimes occurs simultaneously in the right and left organs. These are round nodules with good density, having a clear capsule and a gray-yellow hue.

Occasionally, these types of neoplasms occur:

1. Fibrous histiocytoma - a neoplasm of inflammatory origin;
2. Xanthoma - formation from connective or epithelial tissues, which contains iron pigments, cholesterol esters and neutral fats;
3. Plasmacytoma is a granuloma of the plasmacytic type, the cause is a violation of protein metabolism.

There are also neoplasms called tuberculomas. Such a tumor is one of the clinical forms of tuberculosis, it includes inflammatory elements, areas of fibrous tissue and caseous tissues.

Symptoms

With a tumor in the lungs, there are no symptoms at the initial stage of development, whether it is a benign formation or a malignant one. Lung tumors are quite often detected by chance during routine fluorography, which is why doctors strongly recommend undergoing this examination annually. Clinical manifestations of a benign tumor, especially one that is localized in the periphery, may be absent for several years. Further signs arise depending on the diameter of the neoplasm, how deep it has grown into the tissues of the organ, how close it is to the bronchi, nerve endings, and blood vessels.

Large neoplasms can reach the diaphragm or chest wall, which causes pain behind the sternum and in the region of the heart, and also leads to shortness of breath. If the formation touches the vessels, then blood appears in the sputum due to pulmonary bleeding. With compression by a neoplasm of large bronchi, their patency is disturbed, which has three degrees:

1. Signs of partial bronchial stenosis;
2. Symptoms of valve or valvular bronchial stenosis;
3. Bronchial occlusion.

During the first degree, symptoms are usually absent, occasionally a slight cough may occur. On the X-ray, the neoplasm cannot yet be seen. At the second stage, in that part of the lung that is ventilated by the narrowed bronchus, expiratory emphysema occurs, blood and sputum accumulate, which causes pulmonary edema, and an inflammatory process occurs. Symptoms of this period:

• hemoptysis;
• hyperthermia;
• cough;
• pain syndrome behind the sternum;
• increasing weakness and fatigue.

If bronchus occlusion occurs, suppuration begins, the development of irreversible changes in the tissues of the lung and its death. Symptoms:

• persistent hyperthermia;
• severe pain in the chest;
• development of weakness;
• the appearance of shortness of breath;
• sometimes there is suffocation;
• cough appears;
• sputum contains blood and pus.

If a carcinoma (hormonal tumor) develops, a carcinoid syndrome may develop, which is accompanied by attacks of heat, dermatosis, bronchospasm, diarrhea, and mental disorders.

Common signs of malignant neoplasms include:

• loss of appetite;
• weight loss;
• fatigue;
• increased sweating;
• temperature jumps.

With a debilitating cough, yellow-green sputum is separated. The cough becomes worse when the patient lies down, is in the cold, or exercises. The blood in the sputum is pink or scarlet in color, clots are present. Pain in the chest radiates to the neck, arm, shoulder, back and becomes stronger during coughing.

Diagnostics

During a lung tumor, it is necessary to differentiate the pathology from tuberculosis, inflammation and other pathologies of the respiratory system. For this, diagnostics are carried out in pulmonology: ultrasound, radiography, computed tomography. It is also necessary to conduct percussion (tapping) of the lungs, auscultation (listening), bronchoscopy. In the diagnosis of tumors in the bronchi and lungs, laboratory tests play an important role: a general analysis of urine and blood, a biochemical blood test, blood for specific tumor markers, bacteriological sputum culture, histological examination of the tumor after a biopsy.

Treatment

Therapeutic measures depend on the size of the tumor, its course and nature, as well as the age of the patient. More often, doctors resort to a radical method of treatment - removal of a tumor in the lung through surgery. Surgery to remove the neoplasm is performed by thoracic surgeons. If the formation is not malignant and is localized in the center, then it is preferred to treat it using a laser, ultrasonic and electrosurgical instruments. With peripheral localization, the affected lung is operated on by one of the following methods:

1. Lobectomy - a section of the organ is removed;
2. Resection - removal of a part of the lung with a tumor;
3. Enucleation - exfoliation of a neoplasm;
4. Pulmonectomy - the entire organ is removed, provided that the other lung is functioning normally.

At an early stage of development, the neoplasm can be removed with bronchoscopy, but there is a risk of bleeding. In case of cancer, chemical and radiation therapy is additionally carried out. These methods can reduce the size of the tumor before surgery and kill the remaining cancer cells after the tumor is removed.

Possible Complications

Complications of benign formations are as follows:

• malignancy;
• bronchiectasis (stretching of the bronchus);
• compression of blood vessels, nerve endings and neighboring organs;
• proliferation of fibrous tissue;
• pneumonia with abscess;
• impaired patency and ventilation of the respiratory system;
• bleeding in the lungs.

Lung tumors that are malignant in nature are very dangerous and cause various complications.

Forecast

If the lung tumor is of a benign type, then therapeutic measures, as a rule, give a good result. After removal, such neoplasms rarely recur. The prognosis of malignant tumors depends on the stage at which treatment was started. Five-year survival in the first stage is observed in 90 percent of cases, in the second stage in 60 percent, in the third - about thirty, and in the fourth - only ten.

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 surrounding tissues and metastasize (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

Common Symptoms of Lung Cancer

- Rapid weight loss

- no appetite,

- decline in performance

- sweating,

- unstable temperature.

Specific features:

- cough, debilitating, for no apparent reason - a companion of bronchial cancer. The color of sputum changes to yellow-green. In a horizontal position, physical exercises, in the cold, coughing attacks become more frequent: a tumor growing in the zone of the bronchial tree irritates the mucous membrane.

- Blood when coughing is pinkish or scarlet, with clots, but hemoptysis is also a sign of tuberculosis.

- Shortness of breath due to inflammation of the lungs, the decline of a part of the lung due to tumor blockage of the bronchus. With tumors in the large bronchi, there may be a shutdown of the organ.

- Pain in the chest due to the introduction of cancer into the serous tissue (pleura), sprouting into the bone. At the beginning of the disease, there are no alarms, the appearance of pain indicates an advanced stage. The pain can be given to the arm, neck, back, shoulder, aggravated by coughing.

Source pulmones.ru

Classification

In most cases, lung cancer comes from the bronchi, while the tumor can be located in the central or peripheral zone of the lung. This provision is based on the clinical and anatomical classification of lung cancer, proposed by A. I. Savitsky.

Central cancer:

a) endobronchial;
b) peribronchial nodular cancer;
c) branched.

Peripheral cancer:

a) round tumor;
b) pneumonia-like cancer;
c) cancer of the apex of the lung (Pancost).

Atypical forms associated with the features of metastasis:

a) mediastinal;
b) miliary carcinomatosis;
c) bone;
d) brain, etc.

Depending on which elements of the bronchial epithelium the tumor is formed from, histomorphological forms are distinguished: squamous cell carcinoma (epidermal), small cell (undifferentiated), adenocarcinoma (glandular), large cell, mixed, etc.

Source pulmonolog.com

Diagnostics

For the timely diagnosis of lung tumors, it is necessary to use a set of measures in the study of the patient, which should include the following clinical diagnostic methods.

Detailed clinical examination (anamnesis, examination data, percussion, auscultation).

Laboratory studies (general blood test, sputum examination for the presence of tubercle bacilli, blood, elastic fibers, cell substrate, as well as determination of the height of the polarographic curve of blood serum).

Cytological examination of sputum in order to identify elements of the neoplasm, which must be carried out repeatedly, regardless of other studies.

Complex x-ray examination - multi-axis fluoroscopy, radiography, carried out under certain conditions, layered x-ray examination (tomography, tomofluorography, angiopulmonography).

Bronchoscopy.

Bronchoaspiration biopsy followed by cytological examination of the secretion of the mucous membrane of the bronchi and the tumor.

Bronchography.

Pneumomediastinography.

Source surgeryzone.net

benign

Lung tumors in many cases are not malignant, i.e. the diagnosis of lung cancer in the presence of a tumor is not always made. Often, a lung tumor is benign in nature.

Nodules and dots in the lungs can be seen on an X-ray or CT scan. They are dense, small, round or oval patches of tissue surrounded by healthy lung tissue. The node can be one or more.

According to statistics, neoplasms in the lungs are most often benign if:

Patient under 40 years of age;

He does not smoke

The nodule was found to contain calcium;

Small knot.

A benign lung tumor results from abnormal tissue growth and can develop in different parts of the lungs. Determining whether a lung tumor is benign or malignant is very important. And this should be done as early as possible, because early detection and treatment of lung cancer significantly increases the likelihood of a complete cure and, as a result, the survival of the patient.

Source medintercom.ru

Malignant

The most common lung cancer is lung cancer. Lung cancer is 5 to 8 times more common in men than in women. Lung cancer usually affects patients over 40-50 years of age. Lung cancer is the number one cause of death from cancer among both men (35%) and women (30%). Other forms of malignant lung tumors are recorded much less frequently.
Causes of malignant tumors of the lung

The appearance of malignant tumors, regardless of location, is associated with impaired cell differentiation and proliferation (growth) of tissues occurring at the gene level.

The factors that cause such disorders in the tissues of the lung and bronchi are:

active smoking and passive inhalation of cigarette smoke. Smoking is the main risk factor for lung cancer (90% in men and 70% in women). Nicotine and tar in cigarette smoke are carcinogenic. In passive smokers, the likelihood of developing malignant lung tumors (especially lung cancer) increases several times. Harmful occupational factors (contact with asbestos, chromium, arsenic, nickel, radioactive dust). People associated by profession with exposure to these substances are at risk of developing malignant lung tumors, especially if they are smokers. Living in areas with increased radon radiation - the presence of cicatricial changes in the lung tissue, benign lung tumors prone to malignancy, inflammatory and suppurative processes in the lungs and bronchi.

These factors that influence the development of malignant lung tumors can cause DNA damage and activate cellular oncogenes.

Source in-pharm.ru

Treatment

The choice of treatment depends on the type of cancer, its prevalence, the presence of metastases.

Usually, the treatment of lung cancer is complex and consists of a combination of surgical treatment, chemotherapy, and radiation therapy. The sequence or exclusion of any method is established depending on the type of tumor and the prevalence of the tumor process.

Depending on the indications during the operation, it is possible to remove one (2) lobe of the lung (lobectomy and bilobectomy), the entire lung (pulmonectomy), their combination with lymphadenectomy (removal of lymph nodes).

In the disseminated form of the disease, the main method of treatment is chemotherapy. Radiation therapy is used as an additional method. Surgical intervention is used very rarely.

Benign lung tumors - a collective concept, including a large number of tumors of various origins and histological structures, with different localization and clinical course.
Although benign lung tumors are much less common than cancer, they make up about 7-10% of all lung tumors.
Often the distinction between benign and malignant lung tumors is very conditional. Some benign tumors initially have a tendency to malignancy, with the development of infiltrative growth and metastasis. However, the vast majority of authors believe that the existence of the concept of "benign lung tumors", as a clinical and morphological group, is quite reasonable. Despite the difference in histological structure, benign lung tumors combine slow growth over many years, the absence or scarcity of clinical manifestations before the onset of complications, and most importantly, the relative rarity of malignancy, which sharply distinguishes them from lung cancer or sarcoma and determines other approaches to the choice of tactics and methods of surgical treatment.
Classification and pathological anatomy
From an anatomical point of view, all benign lung tumors are divided into central and peripheral. To central include tumors from the main, lobar and segmental bronchi. The main direction of growth in relation to the bronchus wall can be different and is characterized mainly by endobronchial, extrabronchial or mixed growth. Peripheral tumors develop from more distal bronchi or from elements of lung tissue. They can be located at different distances from the surface of the lungs. There are superficial (subpleural) and deep tumors.. The latter are often referred to as intrapulmonary. They can be localized in the hilar, median or cortical zones of the lung.
Peripheral benign tumors are somewhat more common than central ones. At the same time, they can equally often be localized both in the right and in the left lung. Right-sided localization is more typical for central benign lung tumors. Unlike lung cancer, benign tumors predominantly develop from the main and lobar bronchi, and not from segmental ones.
adenomas are the most common type of histological structure of central tumors, and hamartomas- peripheral. Of all the rare benign tumors, only papilloma has a predominantly central localization, and teratoma located in the thickness of the lung tissue. The remaining tumors can be both central and peripheral, although peripheral localization is more characteristic of neurogenic neoplasms.

Adenoma
All adenomas are epithelial tumors, developing mainly from the glands of the bronchial mucosa. Among all benign lung tumors, adenomas make up 60-65%. In the vast majority of cases (80-90%) they have a central localization.
Central adenomas, starting to develop in the wall of the bronchus, most often grow expansively into the lumen of the bronchus, pushing back the mucous membrane, but not sprouting it. As the tumor grows, compression of the mucous membrane leads to its atrophy, and sometimes to ulceration. With the endobronchial type of adenoma growth, signs of impaired bronchial patency appear quite quickly and grow. With extrabronchial growth, the tumor can spread in the thickness of the bronchus or outside of it. Often there is a combination of different types of tumor growth - mixed growth. Taking into account the benign nature of the course of most carcinoids, cylinder and mucoepidermoid tumors in clinical practice, it is advisable to consider them as benign tumors with a tendency to malignancy and, on this basis, conditionally retain the term “adenomas” for them, which are divided into 4 main types according to the histological structure: carcinoid type (carcinoids), mucoepidermoid type, cylindromatous type (cylindromas) and combined adenomas, which combine the structure of carcinoids and a cylinder.
Carcinoids among all adenomas, are the most common, in 81-86%. These tumors develop from poorly differentiated epithelial cells. The cells are arranged in solid islands in the form of tubes and rosettes, forming mosaic structures.
There are highly differentiated (typical) carcinoids, moderately differentiated (atypical) carcinoids, and poorly differentiated (anaplastic and combined) carcinoids. Tumor malignancy develops in 5-10% of cases. Malignant carcinoid has infiltrative growth and the ability to lymphogenous and hematogenous metastasis to distant organs and tissues - the liver, another lung, bones, brain, skin, kidneys, adrenal glands, pancreas. It differs from cancer in slower growth and much later metastasis, radical operations give good long-term results, and local recurrences are much less common.
Adenomas of other histological types are much less common than carcinoids. They also have the ability to malignancy.

Hamartoma
The term "hamartoma" (from the Greek "hamartia" - error, flaw) was originally proposed in 1904 by E. Albrecht for dysembryogenetic formations of the liver. It has many synonyms. In American literature, hamartomas are often called chondroadenomas.
Hamartoma is the second most common benign lung tumor and the first among the peripheral formations of this localization. More than half of all peripheral benign lung tumors (60-64%) are hamartomas.
Hamartoma is a tumor of congenital origin, in which various elements of germinal tissues may be present. In most hamartomas, islands of mature cartilage of an atypical structure are found, surrounded by layers of fat and connective tissue. There may be slit-like cavities lined with glandular epithelium. The composition of the tumor may include thin-walled vessels, smooth muscle fibers, accumulations of lymphoid cells.
Hamartoma is most often a dense rounded formation, with a smooth or more often finely bumpy surface. The tumor is quite clearly delimited from the surrounding tissue, has no capsule and is surrounded by pushed lung tissue. Hamartomas are located in the thickness of the lung - intrapulmonary or superficial - subpleural. As they grow, they can compress the vessels and bronchi of the lung, but do not germinate them.
Hamartomas are located more often in the anterior segments of the lungs. They grow slowly, and cases of rapid growth are casuistry. The possibility of their malignancy is extremely small, observations of the transformation of a hamartoma into a malignant tumor - hamartoblastoma - are only.

Fibroids lungs are found among other benign tumors of this localization in 1-7.5% of cases. The disease occurs predominantly in men, while both the right and left lungs can be affected equally often. Usually there is a peripheral localization of the tumor. Peripheral fibromas can sometimes connect to a lung narrow pedicle. Fibroids, as a rule, are small in size - 2-3 cm in diameter, but can also reach a gigantic size of a tumor that occupies almost half of the chest cavity. There are no convincing data on the possibility of malignancy of pulmonary fibromas.
Macroscopically, fibroma is a dense whitish tumor node with a smooth smooth surface. With the central localization of fibroma during bronchoscopy, the endobronchial surface of the tumor has a whitish or reddish color due to hyperemia of the mucous membrane. On the mucous membrane covering the fibroma, ulcerations can sometimes be seen.
The tumor has a well-formed capsule, clearly delimiting it from the surrounding tissues. The consistency of the tumor is densely elastic. On the section, the tumor tissue is usually grayish in color, there are areas of different density, sometimes there are foci of ossification, cystic cavities.
.
papilloma - a tumor that develops exclusively in the bronchi, mainly large ones. Another name for papilloma is fibroepithelioma. It occurs quite rarely, in 0.8-1.2% of all benign lung tumors. In most cases, bronchial papillomas are combined with papillomas of the trachea and larynx. The tumor is always covered with epithelium on the outside and grows exophytically, i.e., in the lumen of the bronchus, often completely obturating it. Over time, papillomas can become malignant.
Macroscopically, papilloma is a delimited formation on a stalk or a wide base with an uneven lobed fine- or coarse-grained surface, color - from pink to dark red. In appearance, papilloma may resemble "cauliflower", "raspberries" or "cockscomb". Its consistency, as a rule, is soft-elastic, less often - hard-elastic.

Oncocytoma - an epithelial tumor, most likely arising from the bronchial glands, in which specific large light cells with zosinophilic granularity of the cytoplasm and a small dark nucleus are found - oncocytes, which form the basis of the neoplasm. Oncocytomas are found in the salivary and thyroid glands, kidneys. Primary pulmonary localization of the tumor is extremely rare, about ten such cases have been described in the literature.
Lung oncocytomas are detected in young and middle-aged people, localized in the wall of the bronchus, protruding into its lumen in the form of a polypoid formation, sometimes completely obturating it and growing peribronchially in the form of a clearly defined node. There is also a lung tumor of peripheral localization. Oncocytomas have a thin capsule separating them from surrounding tissues. They have a benign course.

Vascular tumors occur in 2.5-3.5% of all cases of benign lung tumors. None include hemangioendothelioma, hemangiopericytoma and capillary hemangioma. In addition, other vascular tumors are found in the lungs - cavernous hemangioma, glomus tumor, tumors from the lymphatic vessels - lymphangiomas. All of them can have both central and peripheral localization.
All vascular tumors have a rounded shape, a dense or tightly elastic consistency and a connective tissue capsule. Surface color varies from light pink to dark red. The size of the tumor can be different - from a few millimeters in diameter to very large (20 or more cm). Vascular tumors of small size are diagnosed, as a rule, with their localization in large bronchi and the development of hemoptysis or pulmonary hemorrhage.
Hemangioendotheliomas and hemangiopericytomas have a rapid, often infiltrative growth, a tendency to malignant degeneration, followed by a rapid generalization of the tumor process. Many authors suggest classifying these vascular tumors as conditionally benign. Unlike them, capillary and cavernous hemangiomas are not prone to malignancy, are characterized by limited growth, and increase slowly.

Neurogenic tumors can develop from nerve sheath cells (neurinomas, neurofibromas), from cells of the sympathetic nervous system (ganglioneuromas), from non-chromaffin paraganglia (chemodectomas and pheochromocytomas). Of benign neurogenic tumors in the lungs, neurinomas and neurofibromas are predominantly observed, much less often - chemodectomas.
In general, neurogenic tumors are rarely detected in the lungs, accounting for about 2% of all cases of benign neoplasms. They can occur at any age, equally often in both the right and left lung. All neurogenic tumors in the vast majority of cases have a peripheral location. Sometimes they connect with a light stalk. Central tumors with endobronchial localization are very rare. Neurinomas and neurofibromas are sometimes observed simultaneously in both lungs. Multiple neurofibromas of the lungs can be a manifestation of neurofibromatosis - Recklinghausen's disease.
Neurogenic tumors usually grow slowly, in rare cases reaching large sizes. Macroscopically, they are rounded dense nodes with a pronounced capsule, on the cut they have a grayish-yellow color. The question of the possibility of malignancy of neurogenic tumors is highly controversial. Along with the existing opinion about a purely benign course of the disease, a number of authors cite observations of malignancy of neurogenic lung tumors. Moreover, some authors suggest considering neurinomas as potentially malignant neoplasms.

Lipoma - a benign tumor of adipose tissue. It is rare in the lungs. Mostly lipomas develop in large bronchi (main, lobar), the wall of which contains adipose tissue detected by microscopic examination, however, they can also occur in more distal parts of the bronchial tree. Lung lipomas can also have peripheral localization. Lung lipomas are somewhat more common in men, their age and localization are not typical. With the endobronchial location of the tumor, the clinical manifestations of the disease increase as the drainage function of the affected parts of the lung is disturbed with symptoms characteristic of this. Identification of a peripheral lipoma of the lung, as a rule, is an accidental x-ray finding. The tumor grows slowly, malignancy is not typical for it.
Macroscopically, lipomas have a rounded or lobular shape, densely elastic consistency, and a distinct capsule. On the cut, they are yellowish in color, lobed structure. The bronchoscopic picture of endobronchial lipoma is characteristic - a smooth-walled formation of a rounded shape, pale yellow in color. On microscopic examination, the lipoma consists of mature fat cells, with connective tissue septa separating the islands of adipose tissue.
Leiomyoma is a rare benign lung tumor that develops from smooth muscle fibers of the bronchial wall or blood vessels. More common in women. It can have both central and peripheral localization. Central tumors have the appearance of a polyp on a stalk or broad base. Peripheral leiomyomas can be in the form of multiple nodes. Tumors grow slowly, sometimes reaching considerable sizes. Leiomyomas have a soft texture, surrounded by a well-defined capsule.

Teratoma - formation of disembryonic origin, usually consisting of several types of tissues. It may be in the form of a cyst or a dense tumor. It has many synonyms - dermoid, dermoid cyst, complex tumor, embryoma, etc. It is relatively rare in the lungs - about 1.5-2.5% of all cases of benign neoplasms. It is detected mainly at a young age, although observations of teratomas in elderly and even senile people are described. The teratoma grows slowly, in the presence of a cyst due to secondary infection, its suppuration may develop. Possible malignancy of the tumor. Malignant teratoma (teratoblastoma) has an invasive growth, grows into the parietal pleura, neighboring organs. Teratomas are always located peripherally, often there is a lesion of the upper lobe of the left lung. The tumor has a rounded shape, a bumpy surface, a dense or densely elastic consistency. The capsule is clearly defined. The wall of the cyst consists of connective tissue, lined from the inside with a single-layer or stratified epithelium. A dermoid cyst can be single- or multi-chamber, the cavity usually contains yellow or brownish fat-like masses, hair, teeth, bones, cartilage, sweat and sebaceous glands.

Clinic and diagnostics
Benign lung tumors are observed equally often in men and women. Most often they are recognized in young people up to 30-35 years. The symptoms of benign lung tumors are varied. They depend on the location of the tumor, the direction of its growth, the degree of violation of bronchial patency, the presence of complications.
Complications the course of benign lung tumors include: atelectasis, pneumofibrosis, bronchiectasis, abscess pneumonia, bleeding, compression syndrome, tumor malignancy, metastasis.
Benign lung tumors may not have any clinical manifestations of the disease for quite a long time. This is especially true for peripheral tumors. Therefore, in accordance with the characteristics of the clinical course, several stages are distinguished:
Stage I - asymptomatic course;
II stage - with initial and
Stage III - with severe clinical manifestations.
With central tumors, the rate and severity of the development of clinical manifestations of the disease and complications are largely determined by the degree of impaired bronchial patency. There are 3 degrees of violation of bronchial patency:
I - partial bronchoconstriction;
II - valvular or valve bronchoconstriction;
III - bronchial occlusion.
In accordance with the three degrees of violation of bronchial patency, three clinical periods of the course of the disease are distinguished.
First clinical period corresponds to partial bronchoconstriction, when the lumen of the bronchus is still not significantly narrowed. It is most often asymptomatic. Patients sometimes note a cough, the appearance of a small amount of sputum, rarely hemoptysis. The general condition remains good. The radiological picture is often normal. Only sometimes there are signs of hypoventilation of the lung area. The intrabronchial tumor itself can be detected with linear tomography, bronchography, and CT.
Second clinical period associated with the occurrence of the so-called valvular or valve stenosis of the bronchus. It occurs when the tumor already occupies most of the lumen of the bronchus, but the elasticity of its walls is still preserved. With valvular stenosis, a partial opening of the lumen of the bronchus occurs at the height of inhalation and its closure by the tumor during exhalation. In the area of ​​the lung ventilated by the affected bronchus, expiratory emphysema occurs. During this period, complete obstruction of the bronchus may occur due to swelling of the mucous membrane, blood sputum. At the same time, in the lung tissue located to the periphery of the tumor, ventilation disorders and inflammation occur. The clinical symptoms of the second period are already clearly expressed: body temperature rises, cough with mucous or mucopurulent sputum appears, shortness of breath, there may be hemoptysis, chest pains, weakness, fatigue appear.
An X-ray examination, depending on the location and size of the tumor, the degree of bronchus patency, reveals ventilation disorders and inflammatory changes in a segment, several segments, a lung lobe, or in the entire lung. The phenomena of hypoventilation and even atelectasis of the lung area, during this period, can be replaced by a picture of the development of its emphysema and vice versa. The presumptive diagnosis, as in the first period, can be clarified with linear tomography, bronchography, and CT.
In general, the second period is characterized by an intermittent course of the disease. Under the influence of treatment, edema and inflammation in the tumor area decrease, lung ventilation is restored, and the symptoms of the disease may disappear for a certain period.
Third clinical period and its clinical manifestations are associated with complete and persistent obstruction of the bronchus by a tumor, with the development of pulmonary suppuration in the area of ​​atelectasis, irreversible changes in the lung tissue and its death. The severity of the clinical picture largely depends on the caliber of the obstructed bronchus and the volume of the affected lung tissue. Characteristic are prolonged increases in body temperature, chest pain, shortness of breath, sometimes suffocation, weakness, excessive sweating, general malaise. There is a cough with purulent or mucopurulent sputum, often with an admixture of blood. With some types of tumors, pulmonary bleeding may develop.
During this period, partial or complete atelectasis of the lung, lobe, segment with the possible presence of inflammatory purulent-destructive changes, bronchiectasis is determined radiologically. With linear tomography, a “bronchial stump” is detected. The most accurate assessment of the intrabronchial tumor itself and the condition of the lung tissue is possible according to computed tomography.
In a motley uncharacteristic picture of physical symptoms in central lung tumors, dry and moist rales, weakening or complete absence of respiratory sounds, and local dullness of percussion sound dominate. In patients with prolonged obstruction of the main bronchus, asymmetry of the chest, narrowing of the intercostal spaces, deepening of the supraclavicular and subclavian fossae, lagging of the corresponding half of the chest during respiratory movements are revealed.
The severity and rate of development of bronchial obstruction depends on the intensity and nature of tumor growth. With tumors growing peribronchially, clinical symptoms develop slowly, complete obstruction of the bronchus rarely occurs.
Peripheral benign lung tumors in the first, asymptomatic period do not manifest themselves. In the second and third, i.e. in the period of initial and the period of pronounced clinical manifestations, the symptoms and clinic of peripheral benign tumors are determined by the size of the tumor, the depth of its position in the lung tissue and the relationship with the adjacent bronchi, vessels, and organs. A large tumor, reaching the chest wall or diaphragm, can cause chest pain, difficulty breathing; with localization in the medial parts of the lung - pain in the region of the heart. If the tumor causes arrosion of the vessel, hemoptysis or pulmonary hemorrhage appears. When a large bronchus is compressed, the so-called "centralization" of a peripheral tumor occurs. The clinical picture in this case is due to the phenomena of impaired bronchial patency of the large bronchus and is similar to the clinical picture of the central tumor.
Peripheral benign lung tumors are detected, as a rule, without difficulty by conventional x-ray examination. At the same time, they are displayed as rounded shadows of various sizes with clear, but not quite smooth contours. Their structure is often homogeneous, but there may be dense inclusions: clumpy calcifications characteristic of hamartomas, bone fragments in teratomas. A detailed assessment of the structure of benign tumors is possible according to CT data. This method allows you to reliably establish, in addition to dense inclusions, the presence of fat, characteristic of lipomas, hamartomas, fibromas, and fluid in vascular tumors, dermoid cysts. CT scan using the technique of contrast bolus enhancement, it also allows, according to the degree of densitometric indicators of pathological formations, to reliably conduct differential diagnosis of benign tumors with peripheral cancer and metastases, tuberculomas, and vascular tumors.

Bronchoscopy is the most important method for diagnosing central tumors. When it is performed, a biopsy of the tumor is performed, which makes it possible to make an accurate morphological diagnosis. Obtaining material for cytological and histological studies is also possible with peripheral neoplasms of the lungs. For these purposes, transthoracic aspiration or puncture biopsy, transbronchial deep catheterization are performed. Biopsies are performed under X-ray control.
A peculiar clinical picture, the so-called "carcinoid syndrome", in some cases may be accompanied by the course of lung carcinoids. The characteristic properties of these tumors are the secretion of hormones and other biologically active substances.
The clinical picture of carcinoid syndrome is characterized by a recurrent sensation of heat in the head, neck and upper limbs, diarrhea, attacks of bronchospasm, dermatosis, and mental disorders. In women with bronchial adenomas during the period of hormonal changes associated with ovarian-menstrual cycles, hemoptysis may be observed. Carcinoid syndrome occurs infrequently in bronchial carcinoids, only in 2-4% of cases, which is 4-5 times less common than in carcinoid tumors of the digestive tract. With malignancy of adenoma of the carcinoid type, the frequency of development and the severity of the clinical manifestation of the carcinoid syndrome increases significantly.

Malignant tumors of the respiratory organs are among the most common among oncological diseases, they account for every tenth case. The disease affects the epithelium and disrupts air exchange, it is possible for the affected cells to spread throughout the body. You can cope with the danger only if you start treatment at the first or second stage, so the first signs of lung cancer require close attention.

Morbidity statistics and types of pathology

Malignant neoplasms in the lung are one of the most common oncological diseases. According to statistics, more than 60 thousand cases are detected annually in the Russian Federation. Most often, the disease affects people over the age of 50 years.

Until recently, the problem was considered predominantly “male”, but today, due to the prevalence of smoking among women, female morbidity is increasing. Over the past decade, growth has amounted to 10%. Due to air pollution, lung cancer is often diagnosed in children.

Pathology affects the lungs on the right, left, in the center, in the peripheral sections, the symptoms and treatment depend on this.

There are two options:

1. Peripheral symptoms are mild. The neoplasm develops for a long time without noticeable "by eye" manifestations. Pain begins to appear only at the 4th stage. The prognosis is favorable: patients with pathology live up to 10 years.
2. The central form of the disease - the lungs are affected in the place where the nerve endings, large blood vessels are concentrated. In patients, signs of hemoptysis in lung cancer begin early, and an intense pain syndrome pursues. Life expectancy does not exceed five years.

There is no effective treatment for the disease in the central localization.

The main symptoms vary depending on who is diagnosed with the problem: in an adult or a child, in what form it proceeds. For example, cancer of the right lung and cancer of the apex of the lung have excellent clinical presentations.

The sequence of neoplasm formation

Signs of a malignant tumor appear differently depending on the phase of development.

The progression of a neoplasm goes through three stages:

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

At the initial and second stages of the disease, there are no external manifestations. Even when the disease approaches the forms determined on the x-ray, the patient does not feel health disorders. The constant state of health is quite understandable: there are no nerve knots in the respiratory organ, and therefore pain in lung cancer occurs only in advanced phases. The compensatory function is so developed that a quarter of healthy cells are able to provide oxygen to the entire body.

Patients feel normal, they have no desire to see a doctor. Diagnosis of pathology at the initial stage is difficult.

In the second or third phase of tumor development, symptoms of cancer appear at an early stage. Pathology is often disguised as manifestations of colds, pulmonary, chronic diseases.

Initially, the patient notes a developing decrease in vitality. Unmotivated fatigue appears, habitual household or work tasks are difficult, interest in the world around us disappears, nothing pleases.

As the pathology of lung cancer develops, the symptoms and signs are similar to colds, frequent bronchitis and pneumonia. From time to time, the temperature rises to 38 degrees. Therapeutic measures and the use of folk remedies help to recover for a while, but after a week or two, the malaise returns. Poor health, apathy that develops over months, makes the patient go to the doctor's office.

Sometimes the disease does not give characteristic signs until the last stages. The progression of the disease is evidenced by extrapulmonary symptoms that occur due to metastasis: digestive system disorders, problems with the kidneys, bones, back pain, etc. As problems develop, the patient turns to specialists ( neurologist, osteopath, gastroenterologist) and does not suspect the true cause of the ailment.

The first signs of a malignant tumor

Symptoms of lung cancer in women and men in the initial stages are almost the same.

Problems can start with non-specific symptoms:

• fatigue, lethargy;
• decrease in working capacity;
• loss of appetite;
• weight loss.

Most patients do not attach importance to malaise, do not go to the doctor. There are no signs of pathology on examination. There is only a slight pallor of the skin, characteristic of many diseases.

The first signs of lung cancer in men and women require special attention. When diagnosing a malignant tumor in the early stages (first or second), the probability of recovery is 90%, when determining the disease in the third - 40%, in the fourth - only 15%.

Serious problems with the body begin with prolonged malaise, so you should definitely visit a doctor. The oncologist will diagnose and tell you what to do in this situation.

As the disease progresses, a certain list of developing non-specific symptoms is observed: cough, chest pain, hemoptysis, difficulty breathing. If they are present, it is worth paying special attention to your condition and contacting specialists so that doctors can take timely measures.

Body temperature in malignant tumors

How to identify lung cancer? You need to look at an important sign from which malaise begins - fever - a non-specific symptom that accompanies many diseases, including a common cold.

The first symptoms of cancer are always associated with an increase in temperature, which can stay at around 37-38 degrees. The patient should be concerned if such indicators persist for a long time, they become the norm.

As a rule, taking antipyretic drugs, alternative treatment give short-term results. The temperature in lung cancer goes astray for 2-3 days, after which the fever, fever can start again. General fatigue, lethargy, apathy are added to the "bouquet".

Cough as a manifestation of the disease

Cough in lung cancer is one of the brightest manifestations that deserves increased attention. It develops as a response of respiratory tract receptors to prolonged irritation from the outside and from the inside. At the beginning of the progression of the neoplasm, coughing bothers the patient infrequently, but gradually becomes paroxysmal, hoarse.

What is a cough for cancer? Varies from the stage of development of pathology.

The following symptoms are distinguished:

1. Dry cough - almost silent, expectoration is not characteristic of it, there is no relief. He is either stronger or weaker.
2. Strong cough - occurs in attacks that have no apparent reason, caused by physical activity, cooling, uncomfortable posture. Outwardly similar to convulsions, pulmonary spasms. It cannot be stopped, the attack brings the patient to vomiting, loss of consciousness, fainting.
3. Short cough - characterized by brevity and frequency. Accompanied by intense contraction of the abdominal muscles.

Peripheral forms of pathology can occur with little or no cough, which makes medical diagnosis difficult.

Cough in lung cancer is an important manifestation of the disease, the answer to the question of what symptoms should be paid attention to. No need to explain it with a cold, chronic diseases. If the problem persists for a month or more, contact your doctor immediately.

Excretion of sputum and blood

Symptoms of lung cancer in men and women are sputum production when coughing. Outwardly, it resembles mucus; at the fourth stage of the disease, it forms up to 1/5 liter per day.

Symptoms include wheezing in the lungs and hemoptysis. The blood may look like separate elements, "streaks" in the sputum, or foam, giving it a pink color. This symptom may be a manifestation of infectious diseases, such as tuberculosis.

Coughing up blood frightens the patient and makes them seek medical help. To make an accurate diagnosis, the patient is prescribed bronchoscopy. It is extremely difficult to stop hemoptysis, it becomes a companion of a cancer patient until the last days of life.

Sputum in lung cancer in the last stages becomes purulent-mucous. It has a bright crimson color and is similar in consistency to a jelly-like mass.

In severe forms of pathology, pulmonary bleeding is possible, when a cancer patient spits out blood with a full mouth, literally choking on it. Such a process is stopped by a doctor; attempts at home treatment are fruitless and dangerous.

What hurts with lung cancer?

What kind of pain do patients experience? Important signs of lung cancer in women are discomfort in the chest area. They manifest themselves in different intensity depending on the form of the disease. Discomfort becomes especially severe if the intercostal nerves are involved in the pathological process. It is practically intractable and does not leave the patient.

Unpleasant sensations are of the following types:

• stabbing;
• cutting;
• shingles.

They are localized where the malignant tumor is located. For example, if a patient has cancer of the left lung, the discomfort will be concentrated on the left side.

Pain in lung cancer is not always localized in the area of ​​malignant tumor formation. The patient may have pain in the shoulder girdle, this phenomenon is called Pancoast syndrome. Unpleasant sensations spread throughout the body. A cancer patient addresses a problem to a neurologist or osteopath. When it seems that the disease is stopped, the true cause of the ailment is revealed.

In the pre-mortem period, metastases occur in lung cancer (carcinoma). Affected cells spread throughout the body (pathology metastasizes), and the patient may experience discomfort in the neck, arms, shoulders, digestive organs, intense pain in the back and even in the lower extremities.

Pain in lung cancer is complemented by a change in the patient's appearance. In adults, the face becomes gray, “extinct”, a slight yellowness of the skin and whites of the eyes appears. The face and neck appear swollen, and in advanced stages the swelling extends to the entire upper body. Significantly enlarged lymph nodes. There are spots on the patient's chest. The formations outwardly resemble pigmented ones, but have a girdle character and hurt when touched.

Symptoms before death are supplemented by complications of the pathology, one of which is pleurisy - the accumulation of inflammatory fluid, the process develops rapidly. Severe shortness of breath occurs with lung cancer ( medical name - dyspnea), which, in the absence of a therapeutic effect, can be fatal.

Video

Video - symptoms and prevention of lung cancer

Features of the diagnosis of the disease

Diagnosis of pathology can be difficult due to the fact that it disguises itself as a cold. If the back hurts with lung cancer, the patient turns to a neurologist or osteopath, but does not attend an oncologist's appointment.

The doctor's task is to notice non-specific signs, which together, in a certain scenario, form a clear clinical picture. When lung cancer metastases begin, it is easiest to determine the disease, but effective treatment is possible only with an early diagnosis.

The patient is assigned the following studies:

• radiograph in several projections;
• CT and (or) MRI of the chest area;
• sputum examination;
• blood test for tumor markers;
• blood chemistry;
• examination of blood, urine;
• biopsy, etc.

The insidiousness of the disease lies in the fact that at the initial stages it manifests itself as meager symptoms. The occurrence of leg edema in lung cancer, coughing, hemoptysis and other eloquent symptoms occurs at stages 3-4, when the likelihood of healing is low. In order not to start the disease, you need to undergo fluorography at least once a year. Regular examination should be especially important for people who smoke and those who work in hazardous industries.

What lung cancer looks like depends on the characteristics of the case, and the diagnosis is the work of a specialist. However, ordinary citizens need to know what symptoms and signs given by the body, you need to pay attention.

Is there a chance to completely cure a dangerous disease? Yes, if you notice its signs in time and start therapy.

If you find an error, please highlight a piece of text and click Ctrl+Enter. We will fix the mistake, and you will get + to karma 🙂

Basic information

Definition

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

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

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

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

Causes and Prevalence

Table 129

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

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

Anamnesis

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

History of present illness

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

Status of individual systems

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

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

Past illnesses

Other systemic 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 occupational history, travel

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.