Symptoms of advanced lung cancer. Symptoms of abnormal bone and joint. Once lung cancer develops to the advanced stage, because lung cancer cells can produce some special endocrine hormones (heterologous sex hormones), antigens and enzymes, these substances act on bone joints, causing swelling and pain of bone joints, often involving tibia, fibula, ulna, radius and other bone joints, and the ends of fingers and toes often swell into clubbed fingers. X-ray examination showed periosteal hyperplasia.
Second, lung pain involves chest pain, shoulder pain and back pain. Pain is a common symptom in advanced patients, and most lung cancer patients with regional chest spread have chest pain symptoms. Peripheral lung cancer often develops backward and upward, eroding pleura, involving ribs and chest wall tissue, thus causing shoulder and back pain. Such patients rarely have respiratory symptoms.
Third, repeated pleural effusion. In the late stage of lung cancer, patients often have water in their chests. Even if the accumulated water is pumped away, it will often be regenerated soon.
Fourth, the focus involves the throat, and the patient's voice is hoarse. Numerous clinical experiences tell us that the recurrent laryngeal nerve, which controls the left pronunciation function, goes down from the neck to the chest, bypasses the great vessels of the heart and goes up to the throat, thus dominating the left pronunciation organ. Therefore, if the tumor invades the left mediastinum and compresses the recurrent laryngeal nerve, there will be hoarseness, but there will be no symptoms of upper respiratory tract infection such as sore throat.
5. Severe edema on the face and neck. Severe edema is one of the main manifestations of advanced lung cancer. If the tumor invades the right mediastinum and compresses the superior vena cava, it will initially make the jugular vein swell due to poor reflux, and finally lead to edema of the face and neck, which needs timely diagnosis and treatment.
Sixth, it is difficult to breathe and even suffocate. With the worsening of lung cancer, some patients often suffocate and die because of dyspnea.
Other manifestations of lung cancer (1) lesions acanthosis nigricans and dermatitis are more common in adenocarcinoma, and skin pigmentation is caused by melanocyte stimulating hormone (MSH) secreted by tumor, which is more common in small cell carcinoma. Others include scleroderma and hyperkeratosis of palmoplantar skin.
(2) All types of lung cancer in cardiovascular system can have abnormal coagulation mechanism, including wandering venous embolism, phlebitis and non-bacterial embolic endocarditis, which can occur several months before the diagnosis of lung cancer.
(3) The blood system may have chronic anemia, purpura, polycythemia and leukemia-like reactions. It may be caused by reduced iron absorption, shortened life span of erythropoiesis disorder and capillary hemorrhagic anemia. In addition, DIC can appear in lung cancer of various cell types, which may be related to the release of procoagulant factors by tumors. Patients with lung squamous cell carcinoma may be accompanied by purpura.
Diagnostic methods of lung cancer 1. tuberculosis
Tuberculosis, especially tuberculoma (ball) should be differentiated from peripheral lung cancer. Tuberculoma (tuberculoma) is more common in young patients, with a long course of disease, and blood in sputum is rare, and mycobacterium tuberculosis is found in sputum. Imaging is mostly round, which is seen in the upper tip or posterior segment. Small volume, less than 5cm in diameter, smooth boundary, uneven density and calcification. There are often scattered tuberculosis lesions around the tuberculoma, which are called satellite lesions. Peripheral lung cancer is more common in patients over 40 years old, with blood in sputum, and the positive rate of cancer cells in sputum is 40% ~ 50%. X-ray chest film tumors are often lobulated, with irregular edges, small burr shadows, pleural shrinkage and rapid growth. In some cases of chronic pulmonary tuberculosis, lung cancer can occur on the basis of pulmonary tuberculosis, and further sputum cytology and bronchoscopy must be done, and thoracotomy should be performed if necessary.
2. Lung infection
Pulmonary infection is sometimes difficult to distinguish from obstructive pneumonia caused by lung cancer blocking bronchi. However, if pneumonia occurs in the same place many times, we should be vigilant and highly suspect that it is caused by tumor blockage. We should take sputum from patients for cytological examination and fibrotracheal examination. In some cases, it is difficult to distinguish it from peripheral lung cancer when the lung inflammation is partially absorbed and the remaining inflammation is wrapped by fibrous tissue to form nodules or inflammatory pseudotumors. Thoracotomy should be performed on suspicious cases.
3. Benign lung tumor
Benign lung tumors: such as structural tumors, chondromas, fibromas, etc. It is rare, but it must be differentiated from peripheral lung cancer. Benign tumors have a long course of disease and are mostly asymptomatic in clinic. On the X-ray film, it is often a round block with neat edges, no burrs and no leaves. Bronchial adenoma is a low-grade malignant tumor, which occurs mostly in young women. Therefore, clinical symptoms such as pulmonary infection and hemoptysis often appear, and diagnosis can often be made through fiberoptic bronchoscopy.
4. Malignant lymphoma of mediastinum (lymphosarcoma and Hodgkin's disease)