1.Bronchial lung cancer Early stage lung cancer is usually asymptomatic, but various clinical manifestations will appear only in the middle and late stage, the most common ones are cough, bloody sputum, fever, shortness of breath and chest pain, which are the five major symptoms of lung cancer. Tumor compression of the laryngeal nerve may lead to hoarseness. When the tumor invades or presses the pericardium/heart, it may induce panic, palpitation, chest tightness, shortness of breath and other discomforts. A few patients may also have pestle finger, muscle weakness, skin pigmentation, gynecomastia, etc. Chest pain caused by bronchial lung cancer is mostly caused by lesions that have invaded the pleura or chest wall, or metastasized to the pleura. Other metastases to the chest wall invade the diaphragm and cause shoulder pain, which is radiating. The nature of this kind of chest pain can be dull pain, stabbing pain, swelling pain, or severe pain if it is serious. 2.Mediastinal tumor Thymoma is the most common mediastinal tumor, while other tumors such as neurogenic tumors, teratoma and cysts are rarely seen. Most patients have no conscious symptoms in the early stage of thymoma, and most of them are found in the chest X-ray examination. When the tumor compresses the lung or bronchus, there may be cough, chest pain, shortness of breath and hoarseness; in the late stage, there may be enlarged lymph nodes in the neck, even breathing difficulty, swallowing difficulty, increased pressure of superior vena cava and pleural effusion; a few patients have muscle weakness and aplastic anemia. The chest pain caused by mediastinal tumor compression is mostly persistent. Rib and rib cartilage tumors Rib and rib cartilage tumors are mostly seen in adolescents, mainly manifesting as gradually increasing chest pain and local swelling. At the later stage, due to obvious bone destruction, the chest pain is more intense. Patients often have fever, general discomfort, weight loss, anemia and progressive wasting. 4.Pleural tumor Pleural tumor can be divided into two categories: primary and secondary. Secondary tumors are very common, with lung and breast as the sources, and other common primary sites are stomach, ovary and pancreas. Primary pleural tumors are rare, and most of them are mesothelioma originating from pleural mesothelial cells. The common clinical symptoms of pleural tumor include chest pain, dyspnea, cough, followed by weakness, emaciation, fever, sweating, anemia, etc. Secondary pleural tumors still have the discomfort symptoms of the primary lesion. 5.Esophageal cancer The symptoms of early stage esophageal cancer are often mild and short, which are not easy for patients to pay attention to and be alerted. They are mainly manifested as discomfort, burning sensation or pain behind the sternum, foreign body sensation or rubbing sensation when passing food. In the middle and late stage, the symptoms are gradually obvious, mainly manifested as progressive dysphagia, obstruction, retrosternal pain and weight loss. Hoarseness may occur when the tumor compresses or invades the recurrent laryngeal nerve. Tumor infiltration of local blood vessels may lead to bleeding or black stool. Tumor infiltration penetrating the esophagus and invading the mediastinum, trachea and lung hilum will cause severe chest pain, choking cough, chest tightness, bleeding, anemia and weight loss, etc. The typical manifestation of chest pain of esophageal cancer is pain behind the sternum or under the saber process when swallowing, which is burning, pinching or dull pain. 6.hepatocellular carcinoma Early stage hepatocellular carcinoma usually has no symptoms, but with the progress of the disease, patients may experience pain in the liver area, fatigue, poor nutrition, abdominal distension, emaciation, abdominal lumps, fever, jaundice, ascites, etc. Rupture and bleeding of hepatocellular carcinoma nodules may cause acute abdominal pain. Liver cancer located under the right diaphragm often stimulates the diaphragm, resulting in swelling and pain in the back of the right shoulder. 7.Intercostal nerve tumor Benign or malignant intercostal nerve tumor can cause intercostal neuralgia. Its pain is characterized by continuous severe pain, which can be aggravated by deep breathing, coughing and arm raising, etc. The pain is fixed and there is obvious local pressure pain, and local examination can reveal the presence of tumor. 8.Thoracic spinal cord and intravertebral canal tumor The tumor compresses the spinal cord and nerve root of thoracic segment, causing intercostal neuralgia of corresponding segment. 9.Bone tumor Primary and secondary bone tumors, such as invasion of ribs, sternum, clavicle and spine, can cause chest pain. At the beginning, it is intermittent pain, then it develops into persistent and obvious at night. Gradually growing mass is the basis of diagnosis of bone tumor. Malignant bone tumor grows rapidly and has short history. X-rays are of great value in diagnosing bone tumors. 10.Acute leukemia Common sternal pressure pain, acute onset, weakness, progressive worsening of anemia, with fever, bleeding (such as skin petechiae, petechiae, oral and nasal mucosal bleeding, blood in urine, gastrointestinal bleeding), enlarged liver and spleen lymph nodes. 11.Pleural tumor The chest pain caused by primary or secondary tumor of pleura is persistent dull pain, and the patient has a dull and uncomfortable feeling. Primary pleural tumor is mainly pleural mesothelioma, mostly seen in people over 40 years old who are exposed to asbestos. Its clinical characteristics are progressive chest pain, dyspnea, bloody pleural fluid, pleural thickening, weakness, weight loss, irritating dry cough, irregular pleural shape, wavy undulation, or nodular thickening, the thorax is not concave or even convex, different from the pleural thickening caused by chronic inflammation. Pleural metastases are mainly seen in lung cancer combined with pleural metastases. Patients often have coughing and coughing up blood before chest pain, dyspnea and pleural effusion, and rarely have pleural thickening. Although chest pain has a single symptom, the pain characteristics are diverse and the causes are complex. Some people think that through the analysis of 390 cases: (1) cardiogenic pain accounts for 1/3 of the total cases, the pain site is fixed and the degree of pain is intense, and there is no difficulty in diagnosis after medical history, examination, ECG, ultrasound, etc.; (2) pulmonary chest pain accounts for 1/5 of the weak cases, such pain is caused by lesions involving the pleura (3) chest wall chest pain accounts for 2/5, characterized by pain at fixed sites or pain spreading along the intercostal direction, no abnormality in chest film and ECG examination, chest wall pain of unknown cause is mostly self-limiting; (4) chest pain due to other causes is 1/20 weak, with esophageal lesions predominating (13/18), but its chest pain is mostly related to eating, and chest pain caused by cervical spondylosis Mostly seen in spinal and sympathetic cervical spondylosis, both with cervical spondylosis signs, septal hernia is caused by rupture of septal muscle and embedding of abdominal tissue, chest radiograph can determine the diagnosis. Multiple myeloma can be seen as bone destruction, and bone marrow examination can confirm the diagnosis. Therefore, for the progressive chest pain of unknown clinical causes, other factors should be considered after excluding the cardiopulmonary chest wall causes. 2. Diagnosis of lung cancer: (1) middle-aged and elderly people; (2) long-term smoking history; (3) unexplained cough, sputum blood, chest pain, chest tightness, wasting and weakness; (4) cancer cells found by sputum exfoliative cell examination and/or fibrinoscopy; (5) clear lung masses found by X-ray, CT, MRI. (3) Diagnosis of mediastinal tumor: (1) Mostly seen in adults; (2) Progressive cough, chest pain, shortness of breath and hoarseness; in advanced stage, enlarged lymph nodes in the neck, increased pressure in the superior vena cava and pleural effusion may appear; (3) Round or round-like well-defined mass on chest X-ray, located in the anterior mediastinum or on one side; (4) Pathological examination may clarify the diagnosis. Diagnosis of rib and rib cartilage tumor: (1) Mostly seen in adolescents; (2) Gradually increasing chest pain and local swelling, accompanied by fever, general malaise, weight loss, anemia and progressive wasting; (3) X-ray shows limited bone destruction and swelling thinning, with clear tumor boundary and no surrounding reactive sclerosis area, but scattered ossification spots can be seen. Some tumors have increased density, but they are more uniform and of uneven size. The tumor usually grows evenly to the surrounding, making the bone swell or expand to one side. 5. Diagnosis of pleural tumors: Pleural tumors are divided into two categories, primary and secondary. Secondary tumors are very common, with lung and breast as the sources, and other common primary sites are stomach, ovary, pancreas and so on. The diagnosis is the same as primary cancer. In addition, there are clinical manifestations of pleural metastasis, such as chest pain, chest tightness, panic, dyspnea, cough, etc.; X-ray radiography or ultrasound examination often indicates pleural fluid and intrathoracic masses; pleural fluid examination can find cancer cells. Primary pleural tumors are rare, mostly mesothelioma originating from pleural mesothelial cells. The common clinical symptoms include chest pain, dyspnea, cough, followed by weakness, emaciation, fever, sweating, anemia, etc. X-ray mainly shows pleural thickening and pleural fluid; CT and MRI can detect pleural abnormalities, small amount of pleural fluid and small tumor nodules based on pleura earlier and more clearly than X-ray; pleural fluid exfoliation Cytological examination and pleural pathological examination can clarify the pathology and tissue source. 6. Diagnosis of esophageal cancer: (1) middle-aged and elderly people, mostly men; (2) history of long-term overeating, fast swallowing, hot and scalding food or long-term smoking and drinking; (3) clinical manifestations are discomfort, burning or pain behind the sternum, foreign body sensation or rubbing sensation when passing food, etc., with the aggravation of the disease, dysphagia, obstruction, pain behind the sternum, weight loss, etc., some of them also have hoarseness, choking, bleeding, black stool, etc.; (4) the diagnosis of esophageal cancer is based on the following factors (4) Barium X-ray examination can detect local obstruction, filling defect, mucosal destruction and other pathological changes; (5) CT and MRI can detect tumor location, infiltration depth, invasion length of esophagus and relationship with surrounding tissues; (6) Gastroscopy or local lymph node examination can also clarify the pathological nature of tumor. Diagnosis of hepatocellular carcinoma: (1) Mostly seen in middle-aged and elderly people; (2) History of hepatitis B or C; (3) Clinical manifestations include pain in the liver area, weakness, poor appetite, abdominal distension, weight loss, abdominal mass, fever, jaundice, etc. Physical examination can reveal enlarged liver and spleen, and sometimes cancer nodules can be palpated in the liver, and some of them can be accompanied by ascites; (4) Significantly elevated alpha-fetoprotein (AFP), usually greater than 200μg/L; (5) Ultrasonography, CT, lymph node examination can clarify the pathological nature of the tumor. (5) Ultrasonography, CT and MRI can well suggest the diagnosis of hepatocellular carcinoma.