Benign tumors of the lung
Benign lung tumor is an extensive group of diseases, which includes tumors of different origin and cellular structure. Benign tumors of the lungs are found only in 7-10% of cases, all tumors of this organ. The incidence of this disease, both in men and women alike.
Benign tumors of the lung long enough to grow in the early stages does not lead to the destruction of tissues, does not give metastasises in other bodies. In particular, this is the reason of scarce clinical symptoms and late presentation to the doctor.
On average, it takes approximately 3 years before patients begin to show any complaints about the state of his health. Because of the late diagnosis, the process in the lung tissue and bronchi may become irreversible. Also, an extremely high percentage of diagnostic errors that leads patients to the TB doctor, and he, in turn, raises the terrifying diagnosis "Tuberculosis".
What leads to the development of benign lung tumors?
The reason is not completely clear. There are many theories. But none of them proven. Many geneticists focus on genetic predisposition, mutations, long-term effects of carcinogens, various chemicals and toxic substances, radioisotopes, etc.
Risk factors for development of benign tumors can be considered common and chronic bronchitis, asthma, emphysema, tuberculosis, etc. One of the main reasons for the development of all these diseases is considered to be Smoking. To assess the likelihood of development of these diseases use the index of the smoker. It is calculated as: number of cigarettes smoked per day multiplied by the number of months that the person was Smoking (in most cases this is 12). The result should be divided by 20. If the result exceeds 10, the risk of developing the above diseases is high.
Currently health workers in practice are based on the classification, which was adopted in 1973 in the pulmonology Congress of the Surgical community of Moscow and Moscow region. It is based on the anatomical localization of the process, the cellular structure of the tumor and clinical course. According to this classification, benign tumors formed such are grouped as follows:
1. Anatomical localization:
- Central (tumors, developing from the cells of the main, lobar and segmental bronchi). Most are located in the right lung.
- Peripheral tumor develop from the bronchial tubes and their branches). In the right and left lung occur with the same frequency.
2. Cellular structure and clinical course:
- Adenoma-tumor, composed of epithelial cells that develops from the glands of the bronchial mucosa. Grows into the lumen of the bronchus and thus violates its permeability. Its dimensions reach 2-3 cm Malignancy occurs in 5-10% of cases.
- Papilloma develops in the larger bronchi. Consists of connective tissue, which forms multiple spines and a lobed structure. Looks like raspberries.
- A hamartoma (from Greek ἁμαρτία is a mistake, a flaw) is one of the most frequently encountered peripheral lung tumors, which has a rounded shape and smooth surface. Around it formed a capsule. Zlokacestvennoe very rare.
- Fibroid is a tumor that develops from connective tissue with firm consistency, smooth and flat surface, surrounded by a capsule. It can reach giant size, filling half of the chest. Zlokacestvennoe extremely rare.
- Lipoma – tumor composed of fat cells, separated from each other by connective tissue. Identify themrare.
- Leiomyoma – rare tumor in the form of Polipo with a soft body and well developed capsule. Most often develops in women.
- Vascular tumors often have a rounded shape, dense texture. Their localization is different. Color varies from light pink to bright red. Size can reach 20 centimeters. Under the Central growth of the tumor, the vessels can be injured, leading to hemoptysis.
- A teratoma is an embryonic tumor composed of different cells. Has a dense texture and a dense capsule. Diagnosed at a young age. Due to the high probability of infection may lead to abscess formation.
- Neurogenic tumors develop from nerve cells and the membranes of the nerves. Look like dense knots of yellowish color. Located on the periphery.
Pulmonary fibrosis proliferation of connective tissue in the lungs due to prolonged action of inflammation, leading to loss of tissue elasticity and full (or partial) loss of gas exchange function of the affected areas.
Atelectasis pathology, developing as a result of impaired patency of the bronchi and, as a consequence, the loss of ventilation of the lung. The fabric becomes airless and collapses.
Bronchiectasis – pathology, in which the connective tissue is growing around the bronchial tubes, condenses, stretching them.
Abscessing pneumonia is an infectious disease in which lung tissue formed cavities filled with pus.
Compression syndrome – the development of pain syndrome, as a result of compression of the tissues.
Bleeding and malignancy.
Symptomatology depends on the location of swelling, and its size, direction of growth, the degree of impaired patency of the bronchi, the presence or absence of complications.
Due to the inherent benign tumors of slow growth, long enough there may not be any clinical manifestations (especially in peripheral tumors). This is the initial stage of asymptomatic course. As it is called preclinical phase. In the stage of initial clinical symptoms and the stage of severe clinical symptoms the main symptoms are:
- Cough develops in 80-82% of patients with Central tumor growth. Long exists and is not a major concern. Often it may be confused with a "smoker's cough" or with symptoms of colds and viral diseases.
If the tumor does not disturb the function of the bronchi, the sputum when coughing is allocated rarely and has a slimy character. The growth of the tumor, increases the cough, and increases the number of sputum (it can now purchase and purulent).
- A fever develops due to the pulmonary ventilation and infection. Prolonged fever leads to erroneous diagnoses such as "Chronic bronchitis" or "Pneumonia".
- Shortness of breath develops or at the overlap of the lumen of the bronchus by tumor or compression of its outside. The degree of respiratory disorders may be different and depends on the volume of the lung where the broken ventilation function.
- Chest pain can disturb the patients. Often they are associated with a certain position of the body, physical activity. They arise because of compression of the tumor surrounding tissue.
The most accessible and reliable methods of diagnosis are x-ray and endoscopic methods of examination.
In radiography and fluoroscopy of lung visualized in the shadows of various sizes and shapes. To consider in more detail the structure of the tumor using computed tomography with the introduction of contrast agents.
Bronchoscopy is also a reliable methodstudies of Central tumors. When performing bronchoscopy to perform a biopsy of tumor tissue to confirm the purity of the process. For peripheral tumors is carried out transthoracic biopsy of the tumor. It is performed under x-ray control and the tissue sent for histological examination.
All these methods give quite accurate differential diagnosis of such diseases as lung cancer and tuberculosis.
All the treatment of benign tumors of the lungs is the thoracic surgeons. Early operation ensures the prevention of malignancy of the process of developing serious complications and irreversible changes.
At the Central location of the tumor and its small size possible endoscopic removal of the tumor. Most surgeons prefer surgical techniques. However, endoscopic intervention is not always effective due to the possible development of bleeding and, as a consequence, the need for repeated surgical intervention. The alternative is the economical destruction of the bronchus without lung tissue. When developed complications resort to remove one or two lobes of the lung. With the development of severe and irreversible changes it is advisable to conduct the removal of an entire lung (pneumonectomy). For peripheral tumors the use of segmental or marginal resection of the lung.
If you suspect a malignancy during the operation, carried out urgent histological examination. Upon confirmation of results, the volume of surgery increases.