Today, with the rapid development of medical science, as people's living standards improve and they pay more attention to their own health, chest CT examinations are increasingly used in clinical and physical examinations. Since the resolution of chest CT examination is much higher than that of X-ray examination, many small pulmonary nodules are accidentally discovered. What are pulmonary nodules? Do small nodules in the lungs equal lung cancer? What should you do if you find small nodules in the lungs? Its unfamiliar terms and vague connotations make most people nervous, confused and confused.
1. What are small pulmonary nodules
In fact, pulmonary nodules are very common lung lesions, also known as coin-like lesions or spherical lesions, defined as Intrapulmonary, round or nearly round lesions with increased density, surrounded by air-containing lung tissue, with a diameter less than or equal to 3 cm, of which a diameter less than 2 cm is a small nodule, usually 5-9 mm in diameter Those are called micronodules, and those with a diameter less than 4 mm are called miliary nodules. Discovered incidentally during pulmonary examination. Patients with small pulmonary nodules usually have no obvious symptoms or positive signs and are discovered accidentally during physical examination or other disease examinations.
2. Do small lung nodules equal lung cancer
The answer is: absolutely not. From a medical perspective, the causes of small pulmonary nodules are complex and can be simply divided into two categories: malignant pulmonary nodules and benign pulmonary nodules. The most common malignant nodules are lung cancer, and benign pulmonary nodules are more common in pulmonary tuberculosis, hamartomas, fibromas, inflammatory pseudotumors, etc. A large number of studies have confirmed that the size of pulmonary nodules is related to benign and malignant. Among pulmonary nodules with a diameter of 3 cm, the malignant rate is as high as 90%; among small pulmonary nodules less than 2 cm, lung cancer accounts for more than 50%. Nodular lung cancer with a diameter of less than 5 mm is extremely rare; while small isolated pulmonary nodules with clear and calcified borders of less than 8 mm are basically benign.
3. How to determine whether small pulmonary nodules are malignant
The differential diagnosis of small pulmonary nodules is difficult and is easy to be misdiagnosed and missed. In fact, the process of doctors diagnosing small pulmonary nodules is like the police solving a crime. Although benign and malignant pulmonary nodules have their own imaging characteristics on chest " and the phenomenon of "different images and the same disease", the imaging diagnosis results of chest X-ray, CT or positron emission computed tomography (PET-CT) examination can only be regarded as "suspect of lung cancer". The diagnosis of lung cancer is like conclusive evidence when sentencing a criminal. Only pathological finding of cancer cells is the gold standard for diagnosis.
Therefore, doctors will choose different examination methods to collect specimens to confirm the diagnosis based on the patient's specific situation, the size and location of the nodule, these examination methods include sputum to find cancer cells, percutaneous lung cancer under CT positioning Puncture, fiberoptic bronchoscopy and thoracoscopy, etc. If pathological specimens cannot be obtained due to various reasons, clinical exclusion is often used to exclude tuberculosis, inflammatory pseudotumor and other common diseases through symptoms and signs, laboratory test results and diagnostic anti-infective treatment.
CT’s tomographic imaging mode, high resolution and powerful image post-processing functions are by far one of the best non-invasive methods for discovering and diagnosing small pulmonary nodules. Low-dose CT screening can be used as a reliable means to detect early lung cancer, because early lung cancer can manifest as ground-glass lesions (carcinoma in situ or precancerous lesions) less than 10 mm, which is the result of routine chest X-ray or even PET-CT examination. All hard to find.
4. What to do if small pulmonary nodules are discovered
Once small pulmonary nodules are discovered, great attention should be paid to them. We should not be careless and miss the best opportunity for treatment. There is no need to be overly nervous and rush to seek medical treatment, or to listen to the irresponsible advice of laypeople, which may delay the condition of the disease. Once small pulmonary nodules are found, you should promptly go to the respiratory specialist of the relevant hospital for treatment, because the differential diagnosis of lung diseases is the basic skill of respiratory physicians, and their rich clinical experience can reduce misdiagnosis and missed diagnosis.
Patients should be careful to bring all examination data, especially past imaging films, with them when seeing a doctor. This can reduce repeated examinations and prevent patients from going back and forth in vain. Sometimes an old film from a few years ago can help the doctor. Make good judgments quickly.
Small pulmonary nodules often cannot be diagnosed at one time. Patients need to cooperate with regular follow-up visits to observe the dynamic changes in the size, shape and density of small pulmonary nodules, and judge the lesions based on the difference in doubling time of benign and malignant nodules. nature. The so-called doubling time refers to the time required for the diameter of the nodule to increase by 26% and the volume to double.
Generally, it takes 4 to 8 months for small adenocarcinoma, more than 800 days for ground glass lung cancer, more than 500 days for benign nodules, and less than 30 days for inflammation.
Small pulmonary nodules do not mean lung cancer, especially small pulmonary nodules less than 1 cm, more than half of which are benign lesions. Do not act too hastily, and try to rule out benign infectious lesions through various examinations. To prevent overtreatment. Nodules of 1 to 2 cm need to be carefully differentiated between benign and malignant. If anti-inflammatory treatment is ineffective and the gradual increase during follow-up cannot rule out the possibility of malignancy, we must attach great importance to it and perform decisive surgical treatment if necessary.
The follow-up frequency of small nodules is generally: reexamination in 1 to 2 months to observe the development speed, if there is no change, once every 3 months in the first year; once every 6 months in the second year; once every two years. Removal of ground-glass lesions without change can basically rule out the possibility of malignancy.
In short, with the rapid development of medical science today, it is not terrible to find pulmonary nodules. Early detection can lead to early diagnosis and early treatment. The most terrifying thing is that small lung nodules are not discovered in time, thus missing the best opportunity for treatment!