With the progress of medical technology and the improvement of health awareness, people pay more and more attention to physical examination, and many people accidentally find pulmonary nodules in chest CT examination. Get such examination results, many people will panic, but some people do not agree, the regular review of the physical examination report, such as “small nodules” grow into “lumps”, often missed the best time for surgery. So how should we treat pulmonary nodules correctly?
Q1 What is a pulmonary nodule?
Pulmonary nodule refers to a round-like lesion with a diameter of less than 3 cm found in imaging examination (such as CT or chest X-ray). There are many ways to classify pulmonary nodules. Generally speaking, pulmonary nodules are divided into benign and malignant. When the diameter is less than 1 cm, it is often described as a “small nodule”, while when the diameter is less than 0.5 cm, it is called a small nodule. According to the density of nodules, it can be divided into pure ground-glass nodules, partial solid ground-glass nodules and pure solid nodules. According to the number of pulmonary nodules, it can be divided into single nodules and multiple nodules.
Q2 Are lung nodules necessarily malignant?
First of all, most pulmonary nodules are benign and will not become malignant. According to statistics, about 20% of the high-risk groups screened by chest CT can find pulmonary nodules, but more than 95% of them are benign nodules, such as pulmonary inflammation, tuberculosis, hamartoma and fibrous hyperplasia. Secondly, lung nodules are not the same as lung cancer, even cancer, there is no need to panic, because most of the extremely early cancer, as long as through timely and appropriate treatment, can be completely cured. Moreover, the formation of lung cancer is a multi-factor and long-term process. Therefore, once pulmonary nodules are found, there is no need to panic excessively. Although most pulmonary nodules are benign, we still need to pay great attention to them, because there are still a certain proportion of early lung cancer, and some benign lesions may become malignant after a long time. Therefore, it is suggested that the majority of patients should take a scientific attitude and see a doctor in time when facing pulmonary nodules.
Q3 What to do after
finding pulmonary nodules? When finding lung nodules, the most important thing is to seek the help of professional doctors. Choosing experienced doctors and authoritative medical institutions for diagnosis and treatment is the key to ensure the accuracy of diagnosis and treatment effect. Imaging departments and specialists will make comprehensive analysis and judgment according to the clinical risk and imaging characteristics of patients, such as the growth mode, edge shape, internal density, peripheral vascular structure of nodules, and regular review and observation of the growth rate, structure or edge changes of pulmonary nodules are also important bases for judgment. Lung cancer is generally more likely in patients over 40 years of age, in patients with a history of chronic lung disease and family history, in patients with a long history of heavy smoking, in patients with small pulmonary nodules > 1 cm in diameter, in patients with spiculated and lobulated margins, in patients with nodules with heterogeneous internal density showing mixed ground-glass density, and in patients with nodules that gradually increase in size during follow-up. When pulmonary nodules are first found and the doctor judges that the possibility of malignancy is small, the patient will be advised to review chest CT regularly. According to the risk factors of patients and the size and density of nodules, the interval of follow-up is arranged. Some benign lesions such as inflammation may disappear during follow-up. If there is no change in the lesion after three to five years of follow-up, it can be determined as benign. Early surgery (thoracoscopy) should be performed if the possibility of malignancy is suspected at the first time or if the possibility of malignancy cannot be ruled out when the lesion changes during follow-up. The 10-year survival rate of stage I patients treated by surgery has reached more than 90%. Pulmonary nodules can also be eradicated by percutaneous ablation if the patient’s physical condition is not suitable for surgery or is unwilling to undergo surgery. In addition, measures such as quitting smoking and avoiding inhalation of harmful substances can also help prevent the occurrence and deterioration of pulmonary nodules. Maintaining good living habits, enhancing immunity and regular physical examination are effective ways to prevent the deterioration of pulmonary nodules. Q4 Chest X-ray or chest CT is the first choice for pulmonary nodule screening? Many patients choose chest X-ray for physical examination because they are worried about radiation, but the clarity of chest X-ray is low, and it is easy to miss the diagnosis of lesions less than 1 cm. Even if there are lesions in the lung on chest X-ray, the nature of a considerable number of lesions is difficult to determine, and further CT examination is needed. CT can effectively avoid the overlap of lung and other tissues and organs by displaying tissue cross-section and three-dimensional structure images for screening, and has obvious advantages in the diagnosis of lung lesions. In addition, low-dose CT screening produces a very low dose of radiation, which has a very low impact on the human body, and is the preferred method of physical examination for high-risk groups. Tuberculosis
