Occurrence, development and management of pulmonary ground glass shadow/small lung nodules

  A gross glassy lung nodule, called a GGO/GGN, is a cloudy, thin, round nodule with a mild increase in density that looks like a frosted glass nodule, so called. It looks like a small frosted glass nodule.  It is not necessarily cancer. Sometimes, inflammation, bleeding, and fibrosis (scarring after inflammation) in the lungs can cause this change, however, more often than not, it is malignant.  Pulmonary hairy glass shadow/small lung nodules definitely grow gradually from small to large and do not become giant at the beginning. In the initial stage (<1 cm) they are often very pure, low density, round-faced and well-defined, which are not necessarily malignant yet and can be called pure ggo, and after excision they are mostly confirmed as adenomatous atypical hyperplasia (aah, precancerous lesion), or adenocarcinoma in situ (tis, no invasion of the surrounding vascular interstitium, no metastasis), or even in extreme cases they can be microinfiltrating adenocarcinoma (mis, invasion of the surrounding vascular interstitial invasion <5 mm, potential risk of metastasis). < span=""> As it gradually grows worse, it may cause an increase in solid component and become less pure, called mixed GGO/GGN; sometimes, there are also changes such as lobulation, burr, vacuolation, pleural depression, and dense blood vessels, most of which are already malignant, called invasive adenocarcinoma, malignant tumor. It can enter the human blood vessels and develop intrapulmonary or systemic metastasis.  If it is originally caused by inflammation and bleeding in the lung, it will shrink or even disappear, while those created by fibrosis will not change. It takes two to three years or more from the beginning to gradually break through the layers and achieve metastasis, which is related to the immunity of the body. When the lung hairy glass shadow / small nodule shadow is detected, there is no need to panic: when it is very small and pure, it can be followed up and observed, generally speaking <8 mm can be followed up once in 3-6 months ct; if it is already >8 mm, or the follow-up has a tendency to grow, or there are many signs of malignancy, then we should resolve to remove it with early treatment, otherwise the malignant cells will sooner or later occupy an important part of the body. When the body is immune, the growth is slow or even in a quiescent state, but at the right time it will also break out.  The most effective and commonly used treatment for pulmonary hairy glass shadow/small lung nodule is a minimally invasive thoracoscopic lung surgery (video-assisted thoracic surgery, VATS) to remove it completely. Although sometimes small and well hidden in location and not easily found, there are many methods of GGO localization such as locating hooks (Hook-wire), spring coils (coil), intraoperative ultrasound ……. However, there are many methods of GGO localization, such as Hook-wire, coil, intraoperative ultrasound , which can precisely find the lesion during surgery; recently, there is also the use of Stereotactic Radiotherapy (SRT) to treat pulmonary hairy glass shadow/pulmonary nodules, which uses focused radiation to burn and bake the lesion, claiming that it is better than VATS surgery, but it is still controversial. I will say two things about this: First, the lesion can really not exist if it is surgically removed, while SRT may kill it only after a period of time, but it is possible that a cell is very strong and survives. Secondly, there are risks associated with surgery. For elderly people, people who are frail and have many diseases, there may be complications.  In short, pulmonary hairy glass shadow / small lung nodules, although it is difficult to distinguish good from evil, but more often than not, it still acts as a malignant role. Hazy days, tiny particles, staying up all night, smoking and drinking, lack of exercise, and low immunity are all reasons for the occurrence of pulmonary hairy glass shadow/small lung nodules.