A pulmonary nodule is defined as a nodule that is solitary, well-defined, less than or equal to 3 cm in diameter, and surrounded by air-containing lung tissue. Pulmonary nodules with a diameter of more than 3 cm are classified as pulmonary masses. Both pulmonary nodules and pulmonary masses are classified as benign or malignant. Generally speaking, the probability of malignancy in isolated lung nodules is about 20-40%, and the probability of malignancy increases significantly with age. However, if a lung nodule is malignant, early diagnosis of the nature of the nodule and early surgical excision can lead to complete clinical cure and long-term survival, just like normal people.
What is the nature of common lung nodules?
The nature of lung nodules can be divided into two main categories: benign lung nodules and malignant lung nodules.
Small lung nodules: those less than 1.5 cm in diameter can be called small lung nodules;
Malignant nodules: half of the nodules over 2cm are malignant.
Benign nodules: most of the small nodules less than 1 cm are benign. If an isolated lung nodule is malignant, it is usually a lung cancer, in addition to being a carcinoid tumor. Most benign lung nodules are tuberculosis, sarcoidosis, malignant tumors or lung abscesses. Other diseases such as pulmonary atelectasis and extrathoracic lipomas can also form pulmonary nodules.
What is the greatest danger of pulmonary nodules?
The most important thing is to diagnose whether the nodule is benign or malignant at an early stage, and if it is malignant, it should be diagnosed as early as possible and surgically removed as soon as possible.
The clinical treatment process of lung nodules with risk factors for lung cancer: (for reference only, patients with lung nodules should consult a thoracic surgeon for professional consultation and treatment)
How to confirm the diagnosis of lung nodules as lung cancer?
1.Pulmonary puncture examination CT-guided percutaneous pulmonary puncture biopsy is an important method to confirm the benign and malignant nature of lung nodules and lung masses in clinical practice. It has extraordinary diagnostic value in determining the nature of lung nodules.
2, electromagnetic navigation system CT-guided percutaneous puncture lung biopsy Under the electromagnetic navigation system can accurately locate the puncture site, reduce the number of punctures, shorten the puncture time, and reduce the CT radiation dose. This enables precise localization of the lesion and acquisition of pathology, but this new technique is not yet widely available.
3.Fiber bronchoscopy Can most intuitively understand the patient’s airway condition, and give biopsy, puncture biopsy, etc. for the condition found, for the discovery of lung shadows for obtaining pathological diagnosis.
4.Ultrasound bronchoscopy (EUBS) can puncture and biopsy lung nodules or lymph nodes with a diameter of more than 1cm, and its guided lymph node biopsy (EBUS-TBNA) provides a more accurate basis for the staging of lung cancer.
5.Thoracoscopy can be used both as an examination means and a treatment means, and the accuracy of diagnosis is almost 100%. Patients not only get a clear pathological diagnosis, but also can remove nodules through thoracoscopy.
The final diagnosis of lung nodules is confirmed by pathological examination as the gold standard, i.e. taking biopsy of lung nodules.
How are pulmonary nodules treated?
I. Observation Regular review, initially at intervals of 3-6 months. If the lesion remains unchanged, it can be extended to a 6-12 month interval for long-term observation. If the lesion tends to increase in size during the course of observation, it should be surgically removed.
In larger medical centers, minimally invasive thoracoscopic surgery is performed to remove the nodule, and a rapid intraoperative frozen section examination is performed to clarify the nature of the nodule, and if it is malignant, a radical resection and lymph node dissection are performed immediately. Therefore, when small shadows or nodules in the lungs are found on physical examination, a professional thoracic surgeon should be actively consulted to receive formal further examination and timely surgical treatment.
What is the prognosis of minimally invasive lung nodule surgery?
If a lung nodule is pathologically confirmed to be benign, complete clinical cure can be achieved after minimally invasive thoracoscopic surgery to remove it. Even if the lung nodule is early-stage lung cancer, the 5-year survival rate of minimally invasive surgical resection is over 80%.