No need to overstress if lung nodules are found

  Thyroid nodules, small lung nodules, and calcified dots in the breasts are words that are often found in medical examination reports and often make people’s hearts clench when they are carrying the reports. In the eyes of many ordinary people, nodules are a sign of many cancers before they become cancerous. Some even directly draw an equivalence between nodules and calcifications and cancer.  In fact, clinical symptoms such as nodules and calcifications are not all “bad things”, we should not worry too much about these symptoms, nor should we take them lightly. We should not worry too much about these symptoms and should not take them lightly.  A comprehensive judgment is needed to distinguish between good and bad. About 60% of 100 people who undergo medical examination will get a diagnosis report of “small nodules” in the head and neck or lungs. “Small nodules” has become a high-frequency term in medical examinations. Compared to the past decade, incomplete statistics show that the detection rate of “nodules” has increased by about 30%. This explains why so many people are being labeled as “nodules” today.  In fact, the 30% increase in detection rate is due to the advent of new diagnostic equipment, such as ultrasound, low-dose spiral CT, MRI, molybdenum and palladium, and other cancer screening tools. The combined use of these technologies has greatly improved the detection rate of many in situ cancers, especially “small things” less than 1cm in diameter, which have no place to hide in front of advanced diagnostic equipment, including some benign nodules.  In clinical practice, physicians do not only rely on a paper imaging report to determine the benignity and malignancy of “small things”. Physical examination, blood biochemistry, risk factors, past medical history, and family history are all references to accurately determine whether a “nodule” is good or bad. In the diagnosis of breast disease, the diagnostic accuracy of ultrasound and mammogram is 80%, and the sum of the two can increase to 90%. When combined with clinical palpation, the accuracy rate increases to 95 percent.  For common small pulmonary nodules, clinical judgment combined with instrumental diagnosis is also required to make a more objective diagnosis. Thyroid nodules with calcification should be taken seriously. If the patient has a history of tuberculosis, then tuberculosis (old lesions) is more likely. If the patient is over 40 years old and does not have a history of tuberculosis but has a long history of smoking then the possibility of lung cancer should be considered. The location of the lesion in the lung can also be used to make a preliminary judgment. A lesion in the upper lung is more likely to be cancerous, while a lesion in the lower lung is more likely to be tuberculosis.  The gold standard for judging good and bad is also pathology. In clinical diagnosis, pathology is regarded as the “gold standard”. Today, diagnostic imaging is becoming more and more widely used in medical examinations of the general population. For nodules that can be quickly identified as benign or malignant in the clinical setting, we can obtain a definitive diagnosis in a non-invasive manner. For example, for small nodules in the lung, doctors can characterize the nodules more accurately and quickly based on information such as whether the nodules have smooth edges, whether they appear burr-like, whether they are larger than 1 cm in diameter, and where they are located, combined with clinical diagnoses such as the patient’s history of smoking, family history, and symptoms.  However, for some nodules or lesions that are deep in the retroperitoneum or more concealed and difficult to determine the morphology, when it is difficult to diagnose accurately with traditional imaging, we will also perform relevant tests to further characterize the lesions: such as high-resolution CT with thin-layer scanning and 3D image reconstruction for detailed analysis of the nodules, and positron emission tomography (PET) scan if possible to help identify the If possible, PET scan can be performed to help identify the benign and malignant nature, or even puncture biopsy to get the tissue of the lesion and learn the “gold standard” diagnosis in the first place.  In addition, for microscopic lesions deep in the retroperitoneum, such as pancreatic cancer, it is difficult to characterize the lesions with only enhanced CT images, so our doctors need the guidance of ultrasound endoscopy. It can not only directly observe the lining of the gastrointestinal tract, but also perform real-time dynamic ultrasound scanning at the same time, which not only can obtain ultrasound images of the histological features of the digestive tract level and the surrounding blood supply, but also can perform close ultrasound scanning of the abdominal cavity, mediastinum and pelvic organs to locate the location of the lesion faster. By aspirating tissue and cells from the tiny lesions in the neck of the pancreas with a fine puncture needle, we can successfully get the cells and pathological tissue specimens of the pancreatic lesions, which can obtain the precise diagnosis of pathology in the first time and clarify the benignity and malignancy of the lesions, providing an important reference basis for the formulation of subsequent treatment plans.