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Abstract: Non-small cell lung cancer is a malignant neoplastic disease of the lung, of which the most common is adenocarcinoma of the lung. In this case, the patient came to the hospital because he felt pain in the chest, and after perfect examination, he was considered to have lung cancer, so he was hospitalized and treated with surgical resection, and postoperative pathology confirmed the diagnosis of lung adenocarcinoma. The postoperative pathology confirmed the diagnosis of lung adenocarcinoma. The postoperative result is clear, and the patient is in stable condition with improved health.
Basic information】Female, 56 years old
Disease Type】Adenocarcinoma of the lung
Hospital】Tengzhou Central People’s Hospital
Consultation time】May 2022
Treatment plan】left lower lung lobectomy + hilar mediastinal lymph node dissection + drug therapy (Ceftriaxone sodium for injection, Levofloxacin hydrochloride sodium chloride injection, Moxifloxacin hydrochloride sodium chloride injection, Penicillin sodium for injection, Budesonide nasal spray, Terbutaline sulfate nebulizer)
[Treatment period] Hospitalization for 10 days, review after 3 months
Treatment effect】The effect of surgery is clear, the patient is better and her condition is stable
I. Initial consultation
Ms. Li, 56 years old, complained of chest pain, especially when cold or flu, and occasionally saw blood in the sputum, which can disappear by itself, often accompanied by nasal mucosal bleeding, usually do not smoke or contact with smoking environment, so have not been too concerned about it, since retirement nearly 3 years have not had a physical examination, this time to the hospital examination for lung, breast, heart and other related organ tissues to do a more detailed examination. He was found to have an 18 mm sized ground glass nodule in the basal segment of the lower lobe of the left lung, and there was no significant abnormality in the serum markers of the tumor in the blood test. The patient was recommended to be hospitalized for further improvement of examination and treatment.
There was an 18 mm sized ground glass nodule in the basal segment of the left lower lobe.
II. Treatment history
After hospitalization, the patient contacted the imaging department for CT-guided pathological puncture, which was clearly identified as lung adenocarcinoma. Intraoperative rapid cryopathology suggested non-small cell lung cancer, and left lower lung lobectomy + hilar mediastinal lymph node dissection was performed. Postoperatively, he was given intravenous ceftriaxone sodium for injection, levofloxacin hydrochloride sodium chloride injection, moxifloxacin hydrochloride sodium chloride injection, penicillin sodium for injection, and nebulized with budesonide nasal spray and terbutaline sulfate nebulizer. The chest drain was removed on the 3rd postoperative day. The patient did not complain of any special physical discomfort and was discharged after 10 days of hospitalization. The patient was discharged after 10 days of hospitalization. The patient was instructed to be reviewed after 3 months.
III. Treatment effect
After the patient underwent left lower lung lobectomy + hilar mediastinal lymph node dissection, no lymph node metastasis and pleural metastasis were found on perfect pathological examination. After drug treatment, the patient did not complain of any special physical discomfort, and was discharged from the hospital after active treatment with improved health and stable condition. The patient was discharged from the hospital. The patient was asked to come to the outpatient clinic for regular review of the chest CT, and the effect of surgery was clear.
IV. Notes
We are glad that the patient’s chest pain disappeared and his condition was stable after treatment. The patient had early stage lung adenocarcinoma, theoretically the lesion was limited and no lymph node metastasis was found on perfect pathological examination, so the surgical result was very clear, but we cannot exclude the case of new tumor or occult metastasis of tumor cells (not yet manifested on imaging), therefore, regular review is very important.
V. Personal insight
For both elderly and middle-aged people, it is recommended to have regular chest CT examination every year, especially for those who smoke or are exposed to oil fumes, paints, tar and other related substances. Once a pulmonary ground glass nodule is found, it is recommended to review the chest CT once every six months for those who have a ground glass nodule less than 8 mm without obvious short burrs, shallow lobes, pleural traction, etc. For those who have a ground glass nodule larger than 8 mm, the first CT review should be 3 months, and then a review plan should be made according to the relevant situation. For those who consider inflammatory nodules, oral or intravenous antibiotic treatment can be tried, and chest CT should be reviewed regularly to determine whether the ground glass nodules are caused by inflammatory infection. For those with high suspicion of lung adenocarcinoma, timely improvement of pathological examination is needed. After clarification, surgical treatment and, if necessary, chemotherapy, radiotherapy or targeted drug treatment are required.