Patient: due to cough (unable to sleep at night when severe, now reduced)), went to the hospital and found a nodule in the left lung. No treatment Whether gamma knife can be done Laboratory and examination results: sputum: no cancer cells, blood tests (4 items) are within the standard values CT chest scan examination seen: nodule in the upper lobe of the left lung, about 2.4X2.0CM, with burrs visible around it and large pulmonary alveoli visible next to it, and large pulmonary alveoli visible in the middle lobe of the right lung. No nodules or solid lesions were seen in the rest of both lungs. Small lymph nodes in the mediastinum 4R and 6 regions, the larger one about 1.1X1.1CM. no pleural fluid and pericardial effusion were seen. Imaging diagnosis: nodule in the upper lobe of the left lung, tending to be cancerous. Last seen at: Cancer Hospital (Panjiayuan) Please ask Dr. Shang for diagnosis and advice. Hello! After reading your description of your condition, I have the impression that you are experiencing some problems, mainly: 1. cough symptoms. 2. chest CT suggests a nodule less than 3cm in diameter in the left upper lung with burrs, and a combination of large alveoli in the left upper lobe and right middle lobe (size unknown). 3. lymph nodes are visible in the mediastinum (but I don’t know if they are larger there?). Because 4R is on the right and group 6 is on the left) Truthfully, since you are not a professional, the description of the lesion is not comprehensive enough, for example, is the upper lobe of the left lung nodule located in the center of the lung field or around it? Are the bronchi and important blood vessels involved? Is the nodule visible as a burr and does it show signs of lobulation? What is the CT value? Therefore, at this stage, we can only make a diagnostic analysis based on the current data, and we need further information to make an accurate diagnosis. Based on the existing data alone, the possibility of malignancy cannot be ruled out for the lesion in the upper lobe of the left lung (further examination is needed), so now you need to determine several things: 1. Many CT signs can suggest the benignity or malignancy of the lesion, in addition to sputum cytology, tumor marker testing, PET/CT, and even puncture, which is most accurate if pathology results are obtained. 2. Whether metastasis. Here include: 1) whether the mediastinal lymph nodes are metastatic, imaging lymph nodes with short diameter greater than 1cm should be suspected of metastasis, PET/CT is also helpful to determine benign and malignant, and mediastinoscopy can be used to determine if necessary, but the latter belongs to general anesthesia surgery. In addition, even if the mediastinal lymph nodes metastasize, it is helpful to determine whether the left or right mediastinal lymph nodes metastasize. 2) Whether the abdominal organs, brain, and bones metastasize. 3. What is the best treatment. The best treatment for patients with different stages is different: surgery is preferred over gamma knife for pulmonary malignancies without metastases, unless the patient cannot tolerate surgery and needs palliative treatment of the lung lesions at the same time; patients with ipsilateral mediastinal lymph node metastases whose lung itself and lymph nodes can be completely removed are considered for surgical resection in most institutions in China; contralateral mediastinal lymph node metastases cannot be surgically Most institutions do not recommend surgery for radical treatment, but require radiotherapy; extra-pulmonary metastases such as abdominal organs, brain and bone metastases, in general, patients with extra-pulmonary metastases are not suitable for surgery, except for several special cases such as combined single brain metastases and adrenal metastases. 4. Relationship between surgery and other treatments: Generally speaking, surgery is recommended first for most lung malignant tumors other than small cell lung cancer if the patient can tolerate surgery, because surgery plus postoperative comprehensive treatment brings the greatest survival benefit to the patient, that is, the patient can live longer with the best results. Chemotherapy is a systemic treatment, and appropriate chemotherapy can also prolong survival. There are many other methods of systemic treatment, which will not be discussed here. Radiotherapy generally belongs to local treatment methods, gamma knife is a kind of radiotherapy, equivalent to focus radiotherapy, belongs to the palliative treatment methods, can only work on the irradiated area, there is no effect on other places, the impact on survival is not obvious. Although surgery is traumatic, it is still recognized as the best treatment, and many patients have already lost the chance of surgery when it is discovered! After surgery, according to the pathological results, adjuvant radiotherapy should be administered. For patients who have no chance of surgery, they can choose radiotherapy, and for palliative treatment of local lesions, they can choose gamma knife and other treatment methods. At present, there are a lot of tumor treatment methods, should be selected according to the need to be screened, otherwise spending more money is a small matter, affecting the life of the patient is a big matter.