Lung tumor - causes, types, treatment. Symptoms of a tumor in the lungs - stages and treatment Neoplasm of the right lung

18.05.2017

Benign formations in lung tissue are understood as a group of tumors that differ in structure and origin.

Benign ones are detected in 10% of the total number of pathologies detected in the organ. Women and men are susceptible to the disease.

A benign tumor in the lungs is distinguished by its slow growth, absence of symptoms and destructive effect on neighboring tissues in the initial stages. This is why patients seek treatment late medical assistance, being unaware of the presence of pathology.

The reason for the formation of pathologies in the lungs is not fully understood; there are only assumptions in the form of heredity, long-term exposure to toxic substances, radiation, and carcinogens.

The risk group includes people who often suffer from bronchitis, patients with asthma, tuberculosis, and emphysema. Smoking is one of the main factors, according to doctors, that causes the development of tumors.

Each smoker can assess his risk of developing the disease by calculating it using the formula - the number of cigarettes per day is multiplied by the months of smoking experience, and the result is divided by 20. If the resulting figure is more than 10, then the risk of one day being diagnosed with lung tumor high

What types of tumors are there?

All pathological growths are classified according to their main characteristics. By localization:

peripheral (formed in small bronchi, grow deep in the tissue or on its surface) are diagnosed more often than central ones, detected in each of the two respiratory organs equally often;
central (originating in the large bronchi, growing either inside the bronchus or into the lung tissue) are more often detected in the right lung;
mixed.

Based on the tissue from which the tumor is formed, the following are distinguished:

those that are formed from the epithelium (polyp, papilloma, carcinoid, cylindroma, adenoma);
tumors from neuroectodermal cells (schwannoma, neurofibroma);
formations from mesodermal cells (fibroma, chondroma, leiomyoma, hemangioma, lymphangioma);
formations from germ cells (hamartoma, teratoma).

Of the types of growths listed above, benign lung tumors in the form of hamartomas and adenomas are most often detected.

An adenoma is formed from the epithelium, the standard size is 2-3 cm. As it grows, the bronchial mucosa ulcerates and atrophies. Adenomas can develop into cancerous tumors.

The following adenomas are known: carcinoma, adenoid, as well as cylindroma and carcinoid. In approximately 86% of cases, a carcinoid is detected; in 10% of patients, the tumor can mutate into cancer.

Hamartoma is a tumor formed from embryonic tissues (layers of fat, cartilage, glands, connective tissues, lymph accumulations, etc.). Hamartomas grow slowly and do not show symptoms. They are a round tumor without a capsule, the surface is smooth. Rarely degenerate into hamartoblastoma (a pathology of a malignant nature).

Papilloma is a tumor with many outgrowths, formed from connective tissue. It develops in the tissues of large bronchi, sometimes it can block the lumen of the organ and mutate into a malignant formation. Sometimes several tumors of this type are detected at once - in the bronchi, trachea and larynx. In appearance, the papilloma resembles a cauliflower inflorescence, is located on a stalk, also on the base, and has a color from pink to red.

Fibroma is a formation up to 3 cm in size, formed from the connective epithelium. The pathology can affect both lungs and grow to half of the sternum. Neoplasms are localized centrally and peripherally and are not prone to mutation.

Lipoma (also known as a wen) is a tumor of adipose tissue and is rarely detected in the respiratory system. The bronchus is formed in the central part more often than in the periphery. As the lipoma grows, it does not lose its good quality and is distinguished by the presence of a capsule, elasticity and density. More often, a tumor of this type is diagnosed in women, it can be on the base or stalk.

Vascular benign tumors of the lungs (hemangioma of the cavernous and capillary type, hemangiopericytoma, lymphangioma) are detected in 3% of pathological formations here. They are localized both in the center and on the periphery. They are characterized by a round shape, dense consistency, and the presence of a capsule. Tumors grow from 10 mm to 20 cm or more. This localization is detected by hemoptysis. Hemangiopericytoma, like hemangioendothelioma - only according to some signs - are benign lung tumors, since they can grow quickly and become malignant. In contrast, hemangiomas do not grow quickly, do not affect neighboring tissues, and do not mutate.

Teratoma is a benign tumor of the lungs, consisting of a “bouquet” of tissues - sebum, cartilage and hair, sweat glands, etc. It is detected mostly in young people and grows slowly. There are cases of tumor suppuration and mutation into teratoblastoma.

Neuroma (also known as schwannoma) is a tumor of nerve tissue, detected in 2% of all cases of blastomas in the lung. Usually located on the periphery, it can affect 2 lungs at once. The tumor is characterized by the presence of a clear capsule and the round shape of the nodes. Mutation of neuromas has not been proven.

There are other benign lung tumors, which are quite rare - histiocytoma, xanthoma, plasmacytoma, tuberculoma. The latter is a form of tuberculosis.

Clinical picture of a tumor in the lung

Symptoms vary depending on the location of the growth and the size of the pathological formation, the direction of its growth, hormonal dependence, and complications. As mentioned above, benign formations don't announce themselves long time, can grow little by little over the years without disturbing a person. There are three stages of development of neoplasms:

asymptomatic;
initial clinical symptoms;
pronounced clinical symptoms, when benign lung tumors give complications in the form of atelectasis, bleeding, abscess pneumonia, pneumosclerosis, mutation into a malignant neoplasm, metastasis.

The asymptomatic stage of a peripheral tumor, as the name implies, is characterized by the absence of signs. Once the tumor progresses to the next stages, the symptoms will vary. For example, large tumors can put pressure on chest wall and diaphragm, which causes pain in the chest and heart area, shortness of breath. If the vessels are eroded, bleeding in the lungs and hemoptysis is detected. Large tumors, squeezing the bronchi, impair patency.

Benign tumors in the central part of the organ disrupt bronchial patency, causing partial stenosis, with more severe damage - valve stenosis, and with serious disease - occlusion. Each stage is characterized by its own symptoms.

With partial stenosis, the course of the disease does not manifest itself much; sometimes patients complain of coughing with sputum. The disease does not affect general well-being. The tumor is not visible on X-ray; for diagnosis, you need to undergo bronchoscopy and CT.

In the presence of valve stenosis (valvular), the tumor blocks most of the lumen of the organ; when exhaling in the bronchus, the lumen closes, and when air is inhaled, it opens slightly. In the part of the lung where the bronchus is damaged, emphysema is detected. Due to swelling, accumulation of sputum with blood.

Symptoms manifest as cough with sputum, sometimes with hemoptysis. The patient complains of chest pain, fever, shortness of breath and weakness. If at this moment the disease is treated with anti-inflammatory drugs, pulmonary ventilation can be restored, swelling can be relieved and the inflammatory process can be stopped temporarily.

With bronchial occlusion, irreversible changes fragment of lung tissue, its death. The severity of symptoms depends on the volume of tissue affected. The patient is diagnosed elevated temperature, shortness of breath up to attacks of suffocation, weakness, coughing up sputum with pus or blood.

What complications do tumors in the lungs cause?

The presence of a tumor in the lungs and bronchi is fraught with complications that can manifest themselves to one degree or another. The main pathological conditions are listed below:

pneumofibrosis - due to a long inflammatory process, the lung tissue loses its elasticity, the affected area cannot perform a gas exchange function, and connective tissue begins to grow;
atelectasis - impaired bronchial patency leads to loss of ventilation due to changes in the tissue of the organ - it becomes airless;
bronchiectasis - stretching of the bronchi due to the proliferation and compaction of connective tissue next to them;
Abscess pneumonia is an infectious disease characterized by the formation of lung tissue cavities with pus;
compression syndrome – pain due to compression of lung tissue;
mutation into a malignant neoplasm, bleeding in the lungs.

Tumor diagnosis

Considering the asymptomatic course of the disease in early stages, it is not surprising that tumors are detected by chance on x-rays or fluorography. On an x-ray, the tumor looks like a rounded shadow with a clear contour; the structure can be homogeneous and with inclusions.

Detailed information can be obtained using CT, where it is possible to identify not only the tissue of dense neoplasms, but also fatty tissues (lipomas), as well as the presence of fluid (vascular tumors). The use of contrast enhancement on CT allows one to distinguish a benign tumor from peripheral cancer, etc.

Bronchoscopy as a diagnostic method allows you to examine a centrally located tumor and take a fragment for biopsy and cytological examination. For peripherally located tumors, bronchoscopy is performed to identify compression of the bronchus, narrowing of the lumen, changes in angle and displacement of the branches of the bronchial tree.

If a peripheral tumor is suspected, it is advisable to perform a transthoracic puncture or aspiration biopsy under ultrasound or X-ray control. Pulmonary angiography can detect vascular neoplasms. Already at the examination stage, the doctor may note a dullness of sound during percussion, weakening of breathing, and wheezing. The chest looks asymmetrical, and the affected part lags behind the other when breathing.

Treatment of tumors

In general, treatment for benign lung tumors consists of removing them, regardless of the risk of degeneration into malignant neoplasms. The earlier the tumor is detected and removed, the fewer complications after surgery and the risk of developing an irreversible process in the lung.

Tumors localized in central parts, removed by resection of the bronchus. If the tumor is attached to a narrow base, complete resection is prescribed, after which the defect is sutured. If the tumor is attached to a wide base, a circular resection of the bronchus is performed and an interbronchial anastomosis is performed. If the patient has already developed complications in the form of fibrosis, abscesses, then they may prescribe the removal of 1-2 lobes of the lung, and when irreversible changes are detected, the lung is removed.

Tumors localized in the periphery are removed in several ways: enucleation, resection, and, if large, lobectomy. Depending on a number of factors, thoracoscopy or thoracotomy is performed. If the tumor is attached to the organ with a thin stalk, it is prescribed endoscopic surgery. The operation is minimally invasive, but has side effects– there is a risk of bleeding, incomplete tumor removal; bronchological control is required after surgery.

If the thoracic surgeon suspects that the tumor is malignant, urgent histology is performed during the operation - a fragment of the tumor is examined in the laboratory. If the surgeon’s suspicions are confirmed, the operation plan changes slightly, and a surgical intervention is performed, similar to the procedure for lung cancer.

If a benign tumor in the lung is identified and treated in time, the long-term results will be favorable. At radical surgery relapses are rare. For carcinoids, the prognosis is unfavorable; for different types of tumor, the 5-year survival rate ranges from 100 to 37.9%.

Considering the above, you need to take care of your health in a timely manner and do not forget to visit doctors.

Benign lung tumors is a broad concept that implies quite a large number of neoplasms that differ from each other in etymology, morphological structure, place of formation, but have several main common features, these are:

slow growth over several years;
no metastasis or very little spread;
absence of clinical manifestations before complications;
impossibility of degeneration into oncological neoplasms.

Benign lung tumors are a dense nodular formation of an oval or round shape. They develop from highly differentiated cells, which in their structure and functions are in many ways similar to healthy ones. However, the morphological structure of the neoplasm differs significantly from normal cells.

Benign tumor affects the lung much less often than malignant. It is mainly diagnosed in people under forty years of age, regardless of gender.

The methods and tactics of treating this pathology differ significantly from the methods of combating cancerous tumors organ.

The reasons for the appearance of benign tumors today are difficult to clearly identify, since research in this direction continues. However, a certain pattern of this pathology has been identified. Factors that provoke mutation of typical cells and their degeneration into atypical ones include:

heredity;
disorders at the gene level;
viruses;
smoking;
bad ecology;
aggressive UV radiation.

Classification of benign tumors

Benign tumors of the respiratory system are categorized according to the following criteria:

anatomical structure;
morphological composition.

Anatomical study of the disease gives full information about where the tumor originated and in which direction it is growing. According to this principle, lung tumors can be central or peripheral. The central neoplasm is formed from large bronchi, the peripheral one - from distal branches and other tissues.

Histological classification designates tumors in accordance with the tissues from which this pathology was formed. There are four groups of pathological formations:

epithelial;
neuroectodermal;
mesodermal;
germinal, these are congenital tumors - teratoma and hamartoma.

Rarely occurring forms of benign lung tumors are: fibrous histiocytoma (tissues of inflammatory origin are involved), xanthomas (connective or epithelial tissues), plasmacytoma (neoplasm arising in connection with a disorder of protein metabolism), tuberculomas. Most often, the lungs are affected by adenoma of central location and hamartoma with peripheral location.

According to clinical manifestations, three degrees of disease development are distinguished. The key point in determining the stage of growth of the central tumor, bronchial patency is determined. So:

the first degree is marked by partial blockage;
the second is manifested by impaired respiratory function during exhalation;
third degree is complete dysfunction of the bronchus, it is excluded from their breathing.

Peripheral tumors in the lungs are also determined by three stages of pathology progression. On first clinical symptoms do not appear, in the second they are minimal, the third stage is characterized by acute symptoms pressure of the tumor on nearby soft fabrics and organs appear painful sensations in the sternum and heart area, difficulty breathing appears. When the tumor damages the blood vessels, hemoptysis and pulmonary hemorrhage occur.

Depending on the degree of development of the tumor, associated symptoms. On initial stage when bronchial passage is a little difficult, special symptoms practically not observed. From time to time you may experience a cough with copious sputum, sometimes with signs of blood. General health is normal. On at this stage It is impossible to detect a tumor using X-rays; more in-depth research methods are used to diagnose it.

At the second stage of tumor development, bronchial valve stenosis is formed. With a peripheral tumor, the inflammatory process begins. At this stage, anti-inflammatory therapy is used.

Complete bronchial obstruction occurs at the third clinical stage of a benign neoplasm. The severity of the third degree is also determined by the volume of the neoplasm and the area of the organ affected by it. Given pathological condition accompanied by high temperature, attacks of suffocation, coughing with purulent sputum and blood, and even pulmonary bleeding. A third-degree benign lung tumor is diagnosed using X-rays and tomography.

Diagnosis of benign neoplasms

Benign tumors are easily identified using X-ray examination and fluorography. On x-rays, the pathological compaction is indicated as a dark round spot. The structure of the neoplasm has dense inclusions. The morphological structure of the pathological compaction is studied using CT scan of the lungs. Using this procedure, the density of atypical cells and the presence of additional inclusions in them are determined. The CT method allows you to determine the nature of the formation, the presence of metastases and other details of the disease. Bronchoscopy is also prescribed, together with which a biopsy is performed for deep morphological research neoplasm material.

Neoplasms of a peripheral location are studied using transthoracic puncture or biopsy under ultrasound guidance. Pulmonary angiography examines vascular tumors in the lungs. If all the diagnostic methods described above do not allow obtaining complete data on the nature of the tumor, then thoracoscopy or thoracomy is used.

Treatment of lung tumors

Any pathological change in the body requires due attention from medicine and, of course, a return to a normal state. The same applies to tumor neoplasms, regardless of their etymology. A benign tumor must also be removed. From early diagnosis The degree of complexity of the surgical intervention depends. Removing a small tumor is less traumatic for the body. This method makes it possible to minimize risks and prevent the development of irreversible processes.

Centrally located tumors are removed using gentle bronchial resection without damaging the lung tissue.

Neoplasms on a narrow base undergo fenestrated resection of the bronchial wall, after which the lumen is sutured.

The tumor in the wide part of the base is removed by circular resection, after which an interbronchial anastomosis is performed.

In severe stages of the disease, when pathological seals in the respiratory organ grow and cause a number of complications, the doctor decides to remove its lobes. When irreversible processes begin to appear in the lungs, pneumonectomy is prescribed.

Lung neoplasms that are peripherally located and localized in the lung tissue are removed using enucleation, segmental or marginal resection.

Large tumors are removed using lobectomy.

Benign neoplasms in the lungs with a central location, which have a thin stalk, are removed endoscopic method. When performing this procedure, there is a risk of bleeding, as well as incomplete removal of tumor tissue.

If there is a suspicion of a malignant tumor, then the material obtained after removal is sent to histological examination. In the case of a malignant tumor, the entire spectrum is performed necessary procedures with this pathology.

Benign lung tumors respond well to treatment. Once removed, their reoccurrence is quite rare.

The exception is carcinoid. The prognosis for survival with this pathology depends on its type. If it is formed from highly differentiated cells, then the result is positive and patients are 100% free from this disease, but with poorly differentiated cells the five-year survival rate does not exceed 40%.

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Benign lung tumors are among the largest group of atypical formations. They are characterized by a large growth of pathological tissues, which are located in the pulmonary, bronchial and pleural areas of the human body.

Benign tumors may differ from each other:

origin;
histology;
location;
signs of illness.

In most cases, benign neoplasms in the pulmonary region account for only 7 to 10% of all tumors. The disease develops equally in both men and women. Experts diagnose a benign tumor in people under 35 years of age.

Benign formations grow very slowly and do not destroy internal organs and do not have metastases. The tissues that surround the growths turn into a connective capsule over time.

Benign lung tumor: symptoms

The manifestation of the disease depends on the size of the benign formation, its location, direction of growth, the activity of hormones, and so on. The disease may develop without any obvious signs.

The development of growths is divided into stages:

no symptoms;
with initial clinical symptoms;
With severe symptoms, in which complications are observed.

A benign formation that occurs without signs of disease can only be detected through a medical examination. At the initial and severe stages, the signs of the disease depend on the depth of the tumor, its relationship to the bronchial system, blood vessels and blood flow of tissues.

A benign lung tumor that is large in size can reach the diaphragmatic area or affect the chest wall. Due to this location, a person experiences pain in the area of the heart, and shortness of breath may occur. When erosion is detected in a benign tumor, the patient coughs up blood, as well as bleeding in the lungs.

If the patency in the bronchial area is impaired, this is due to compression of the large bronchi by the neoplasm.

Experts distinguish several degrees of bronchial obstruction:

Ι with slight stenosis;
ΙΙ is associated with valvular or ventral bronchial stenosis;
ΙΙΙ type consists of bronchial occlusion.

Also, for greater convenience, doctors distinguish between several periods.

The first stage of a benign tumor is characterized by a narrowing of the lumen in the bronchial system, so this disease occurs without symptoms. Experts note that in rare cases, a cough with sputum is observed. Very rarely there are blood impurities. The patient is in stable condition.

It is impossible to determine the presence of a formation using x-rays or fluorographic examination. It is possible to detect the disease only with bronchoscopy, bronchography and computed tomography.

At the second stage of a benign lung tumor, stenosis occurs. It is associated with a neoplasm that can occupy most of the lumen in the bronchi, but at the same time retains its elasticity. At this point, emphysema develops. In such cases, specialists most often detect bronchial obstruction, which occurs due to swelling of the mucous membranes and sputum. Processes of inflammation and ventilation disturbances occur near the growth.

The patient is able to notice the first signs of the disease. A person’s body temperature begins to increase, purulent and wet cough interspersed with blood, shortness of breath is noticeable. Severe chest pain may also occur. The patient begins to get tired and fatigued very quickly, and pronounced weakness of the body appears.

When conducting a medical examination, it is possible to identify deviations in normal ventilation of the lungs, as well as in its segments in which the inflammatory process occurs. At this point, atelactasis and emphysema may develop.

With the help of competent treatment, specialists can reduce pulmonary edema, reduce the inflammatory process, and restore proper ventilation. Symptoms of a benign tumor of the disease may disappear for an indefinite period of time.

The third stage of benign neoplasm has character traits with complete and persistent obstruction of the bronchus. Suppuration of the lung in the area of atelactasis develops with great speed. At this moment, tissue cell death occurs, which leads to irreversible processes in the respiratory system of a sick person.

This stage is characterized by a general increase in body temperature, which does not decrease for a long period of time. Pain syndrome appears in thoracic region, severe shortness of breath occurs, which can even progress to the stage of suffocation. A sick person's body sweating increases. The patient is suffering severe weakness and fatigue. IN purulent mucous Drops of blood may be present when coughing. In some cases, bleeding in the lungs may occur.

X-ray examination can detect atelactasis with damage to the lung, as well as a purulent-inflammatory process and bronchiectasis. During examination using linear computed tomography, a bronchial stump can be detected.

A specialist can make a diagnosis and prescribe treatment only based on the results of a CT examination.

Benign lung tumor: treatment

Treatment of this disease must begin as early as possible. This will help prevent the growth from increasing, and will also help completely get rid of the symptoms of the disease.

First of all, experts note that therapy aimed at relieving the inflammatory process in the lungs does not give any result. They recommend removing such growths through surgery.

Just started on time medical examination and the operation performed can reduce the likelihood of irreversible processes occurring in human body. This will also reduce the risk of postoperative complications.

In most cases, doctors use thoracoscopy to remove a benign tumor. The reappearance of tumors in medicine is very rare.

Central benign neoplasms are excised using the method of economical bronchial resection. Growths that have a thin main part are removed using fenestrated resection of the bronchial wall. After which the wound is sutured or a bronchotomy is performed. For disease with a thick stalk, a circular resection is used and an anastomosis is performed.

If the formation is complicated, then specialists resort to surgical intervention with excision of one to two lobes of the lung. If the disease has affected the entire lung, then a pneumectomy is performed.

If there is a suspicion of a malignant tumor, a histological examination of the material taken during the operation will be carried out. If the result of the study shows a malignant formation, then the surgical field will be enlarged until the malignant growth is completely excised.

A lung tumor does not consist solely of neoplasms in the lung tissue. In this disease, the appearance of cells significantly different in structure from healthy ones occurs in the lungs, bronchial tree and pleura. In pulmonology, diagnostics divides formations in the lungs into malignant and benign, depending on the degree of differentiation. The first, in turn, are primary, arising directly in the organs of the respiratory system, or secondary, which are metastases from other organs.

The most common disease among all cancers is lung cancer, it also leads to the largest percentage of deaths - death occurs in thirty percent of cases, which is more than with cancer of any other organ. The number of tumors that are detected in the pulmonary system and are malignant in nature is 90 percent of all neoplasms. Males are approximately eight times more likely to suffer from malignant pathologies of the tissues of the lungs and bronchi.

Reasons for development

Unlike similar diseases of other organs, the causes of diseases of the pulmonary system that have a tumor form are known. The main reason why a tumor may appear in the lungs is heredity. Most often, tumors in the lungs are formed under the influence of carcinogens contained in cigarette smoke, and both active and passive smokers are at risk. Factors leading to pathological cell division are divided into:

Exogenous - smoking, exposure to radiation, living in an environmentally polluted area, exposure to chemicals on the body;
Endogenous – age-related changes, frequent bronchitis and pneumonia, bronchial asthma.

People at risk should be examined every six months, while others should undergo fluorography once a year.

Classification

Mostly malignant tumors in the lungs arise from bronchial tree, while the neoplasm can be localized in the peripheral or central part of the organ. Based on location, there are different forms of malignant tumors. With a peripheral location, the development of a round tumor, cancer of the apex of the lung, or pneumonia-like cancer is possible. With central localization, branched, peribronchial nodular or endobronchial cancer may occur. Metastatic tumors can be brain, bone, mediastral and others. By histological structure Doctors identify the following types of cancer:

Squamous - from epidermal cells;
Lung adenocarcinoma – from glandular tissues;
Small cell and large cell – undifferentiated tumors;
Mixed - a neoplasm from several types of tissue;
Lung sarcoma - develops from connective tissue;
Pulmonary lymphoma - from lymphoid formations of the bronchopulmonary system.

Benign lung tumors are classified according to their location:

Peripheral - the most common type, arising from the small bronchi. Such formations can grow both on the surface of the tissue and inside it;
Central - formed from the tissue of large bronchi, they tend to grow into the tissue of the lung itself or into the middle of the bronchus, mainly diagnosed in the right organ;
Mixed.

According to the type of tissue from which the tumor is formed, it can be:

epithelial - for example, adenoma or polyp;
mesodermal – leiomyoma, fibroma;
neuroectodermal - neurofibroma, neuroma;
germinal (congenital type) – teratoma and hamartoma of the lung.

Focal formations of the lungs in the form of adenomas and hamartros occur more often than others and are diagnosed in seventy percent of benign lung tumors.

Adenoma - is formed from epithelial cells and in ninety percent of situations is localized in the center of large bronchi, causing airflow obstruction. Generally, the size of adenomas is about two or three centimeters. During growth, the neoplasm leads to atrophy and ulceration of the bronchial mucous membranes. In rare cases, a neoplasm of this type becomes malignant.
Hamartoma is a formation of embryonic origin, consisting of embryonic elements such as cartilage, fat accumulations, muscle fibers, and thin-walled vessels. Most often it is localized in the anterior segment along the periphery of the lung. A tumor grows in the tissue of an organ or on its surface. The formation is round in shape, has a smooth surface, there is no capsule, there is a restriction from neighboring tissues. As a rule, the formation grows slowly and asymptomatically, and malignancy into hamartoblastoma occasionally occurs.
Papilloma is another name for fibroepithelioma. It is formed from stroma of fibrous tissue and has multiple outgrowths in the form of papillae. It affects large bronchi and grows inside them, often leading to complete blockage of the lumen. There are frequent cases of simultaneous occurrence with neoplasms of the trachea or larynx. Often malignant, the surface is lobulated, similar in appearance to a raspberry or cauliflower inflorescence. The tumor may be broad-based or pedunculated. The formation is pink or dark red in color, soft-elastic in structure.
Pulmonary fibroma - grows from fibrous tissue and can grow in size such that it takes up half the volume of the chest. Localization is central if large bronchi are affected or peripheral if other parts are affected. The node has good density, as well as a capsule, the surface is pale or reddish. Such formations never degenerate into cancer.
Lipoma - a tumor that is extremely rare and consists of fat cells that are separated from each other by septa of fibrous tissue, is mainly discovered by chance during an x-ray. Most often localized in the main or lobar bronchi, less often in peripheral part. The abdomino-mediastral type of neoplasm, which originates from the mediastinum, is a common one. The formation is characterized by slow growth and does not become malignant. The tumors are round in shape, densely elastic in consistency, and have a clearly defined yellow capsule.
Leiomyoma is a rare type that arises from smooth muscle fibers in the walls of the bronchi or their vessels. Women are more susceptible to the disease. Localized in the peripheral or central lobe, they externally resemble a polyp on a broad base or stalk, or have the appearance of multiple small nodes. It grows very slowly, but over years of asymptomatic growth it can grow very large. It has a well-defined capsule and a soft consistency.
Teratoma is a dermoid or embryonic cyst (an abnormal accumulation of germ cells). Dysembryonic solid tumor with a distinct capsule within which tissue can be found different types(sebaceous masses, bones, teeth, hair, sweat glands, nails, cartilage tissue etc.). It is diagnosed in youth, grows slowly, sometimes suppurates or malignizes into teratoblastoma. Localized exclusively in the periphery, mainly at the top of the left lung. At large sizes the tumor may rupture, causing an abscess or pleural empyema.
Vascular tumors - pulmonary hemangioma, lymphangioma - are diagnosed in three percent of cases. Localized in the center or in the periphery, round in shape, dense elastic consistency with a connecting capsule. Their color can be pink or dark red, their diameter varies from two millimeters to twenty or more centimeters. If there is a tumor in the large bronchi, blood streaks with sputum appear.
Neurogenic tumors - occur in two percent of cases and contain nerve tissue. Localization is more often in the periphery, sometimes they occur simultaneously in the right and left organs. These are round nodules with good density, having a clear capsule and a gray-yellow tint.

Rarely, the following types of neoplasms occur:

Fibrous histiocytoma is a neoplasm of inflammatory origin;
Xanthoma is a formation of connective or epithelial tissues that contains iron pigments, cholesterol esters and neutral fats;
Plasmacytoma is a granuloma of the plasmacytic type, the cause is a violation of protein metabolism.

There are also neoplasms called tuberculomas. This tumor is one of the clinical forms tuberculosis, it includes inflammatory elements, areas of fibrous tissue and caseous tissue.

Symptoms

With a tumor in the lungs, there are no symptoms at the initial stage of development, whether it is a benign formation or a malignant one. Lung tumors are often detected randomly during routine fluorography, which is why doctors strongly recommend undergoing this examination annually. Clinical manifestations of a benign tumor, especially one that is localized in the periphery, may be absent for several years. Further symptoms arise depending on the diameter of the neoplasm, how deeply it has grown into the tissue of the organ, how close it is to the bronchi, nerve endings, and vessels.

Large tumors can reach the diaphragm or chest wall, which causes pain behind the sternum and around the heart, and also leads to shortness of breath. If the formation touches the vessels, then blood appears in the sputum due to pulmonary hemorrhage. When large bronchi are compressed by a neoplasm, their patency is impaired, which has three degrees:

Signs of partial bronchial stenosis;
Symptoms of ventricular or valvular bronchial stenosis;
The occurrence of bronchial occlusion.

During the first stage, symptoms are usually absent, although a slight cough may occasionally occur. The tumor cannot yet be seen on x-ray. At the second stage, in the part of the lung that is ventilated by the narrowed bronchus, expiratory emphysema occurs, blood and sputum accumulate, which becomes the cause pulmonary edema, an inflammatory process occurs. Symptoms of this period:

hemoptysis;
hyperthermia;
cough;
chest pain syndrome;
increasing weakness and fatigue.

If bronchial occlusion occurs, suppuration begins, the development of irreversible changes in the lung tissue and its death. Symptoms:

persistent hyperthermia;
severe pain in the chest;
development of weakness;
the appearance of shortness of breath;
sometimes suffocation occurs;
cough appears;
the sputum contains blood and pus.

If carcinoma (hormonal tumor) develops, carcinoid syndrome may develop, which is accompanied by hot flashes, dermatosis, bronchospasm, diarrhea, mental disorders.

TO common features malignant neoplasms include:

loss of appetite;
weight loss;
fatigue;
increased sweating;
temperature jumps.

With a debilitating cough, yellow-green sputum is released. The cough becomes worse when the patient lies down, is in the cold, or is engaged in activities. physical exercise. Blood in the sputum is pink or scarlet in color, and clots are present. Pain syndrome in the chest radiates to the neck, arm, shoulder, back and becomes stronger during coughing.

Diagnostics

During a lung tumor, it is necessary to differentiate the pathology from tuberculosis, inflammation and other pathologies respiratory system. For this purpose, diagnostics are carried out in pulmonology: ultrasound, radiography, computed tomography. It is also necessary to perform percussion (tapping) of the lungs, auscultation (listening), and bronchoscopy. When diagnosing tumors in the bronchi and lungs important role laboratory tests play: general analysis of urine and blood, biochemical analysis blood, blood for specific tumor markers, bacteriological culture sputum, histological examination of the tumor after biopsy.

Treatment

Therapeutic measures depend on the size of the tumor, its course and nature, as well as the age of the patient. More often, doctors resort to radical way treatment - removal of a tumor in the lung through surgery. Surgery to remove the tumor is performed by thoracic surgeons. If the formation is not malignant and is localized in the center, then it is preferable to treat it using a laser, ultrasound and electrosurgical instruments. In case of peripheral localization, the affected lung is operated on using one of the following methods:

Lobectomy – a section of an organ is removed;
Resection – removal of part of the lung with a tumor;
Enucleation – desquamation of the tumor;
Pulmonectomy - the entire organ is removed, provided that the other lung is functioning normally.

At an early stage of development, the tumor can be removed during bronchoscopy, but there is a risk of bleeding. For cancer, chemical and radiation therapy is additionally performed. These methods can reduce the size of the tumor before surgery and kill the remaining ones. cancer cells after removal of the tumor.

Possible complications

Complications of benign formations are as follows:

malignancy;
bronchiectasis (stretching of the bronchus);
compression of blood vessels, nerve endings and neighboring organs;
proliferation of fibrous tissue;
pneumonia with abscess;
violation of the patency and ventilation of the respiratory system;
bleeding in the lungs.

Malignant lung tumors are very dangerous and cause various complications.

Forecast

If the lung tumor is benign, then therapeutic measures, as a rule, give good result. After removal, such tumors rarely recur. The prognosis of malignant tumors depends on the stage at which treatment was started. Five-year survival in the first stage is observed in 90 percent of cases, in the second stage in 60 percent, in the third - about thirty, and in the fourth - only ten.

It is possible to detect a tumor in the lungs and determine what it may be with a detailed examination. People are susceptible to this disease different ages. Formations arise due to disruption of the process of cell differentiation, which can be caused by internal and external factors.

Neoplasms in the lungs are a large group of various formations in the lung area that have characteristic structure, location and nature of origin.

Neoplasms in the lungs can be benign or malignant.

Benign tumors have different genesis, structure, location and various clinical manifestations. Benign tumors are less common than malignant tumors and account for about 10% of total number. They tend to develop slowly and do not destroy tissue, since they are not characterized by infiltrating growth. Some benign tumors tend to transform into malignant ones.

Depending on the location there are:

Central – tumors from the main, segmental, lobar bronchi. They can grow inside the bronchus and surrounding lung tissue.
Peripheral - tumors from surrounding tissues and walls of small bronchi. They grow superficially or intrapulmonarily.

Types of benign tumors

There are the following benign lung tumors:

Briefly about malignant tumors

Increase.

Lung cancer (bronchogenic carcinoma) is a tumor consisting of epithelial tissue. The disease tends to metastasize to other organs. It can be located in the periphery, the main bronchi, or grow into the lumen of the bronchus or organ tissue.

Malignant neoplasms include:

Lung cancer has the following types: epidermoid, adenocarcinoma, small cell tumor.
Lymphoma is a tumor that affects lower sections respiratory tract. It may occur primarily in the lungs or as a result of metastases.
Sarcoma is a malignant formation consisting of connective tissue. Symptoms are similar to those of cancer, but develop more quickly.
Pleural cancer is a tumor that develops in the epithelial tissue of the pleura. It can occur primarily, and as a result of metastases from other organs.

Risk factors

The causes of malignant and benign tumors are largely similar. Factors that provoke tissue proliferation:

Smoking active and passive. 90% of men and 70% of women who have been diagnosed with malignant tumors in the lungs are smokers.
Contact with hazardous chemicals and radioactive substances due to professional activity and due to pollution environment areas of residence. Such substances include radon, asbestos, vinyl chloride, formaldehyde, chromium, arsenic, and radioactive dust.
Chronic respiratory diseases. The development of benign tumors is associated with the following diseases: Chronical bronchitis, chronic obstructive pulmonary disease, pneumonia, tuberculosis. The risk of malignant neoplasms increases if there is a history of chronic tuberculosis and fibrosis.

The peculiarity is that benign formations can be caused not by external factors, but by gene mutations and genetic predisposition. Malignancy and transformation of the tumor into malignant also often occur.

Any lung formations can be caused by viruses. Cell division can be caused by cytomegalovirus, human papillomavirus, multifocal leukoencephalopathy, simian virus SV-40, and human polyomavirus.

Symptoms of a tumor in the lung

Benign lung formations have various signs that depend on the location of the tumor, its size, existing complications, hormonal activity, the direction of tumor growth, and impaired bronchial obstruction.

Complications include:

abscess pneumonia;
malignancy;
bronchiectasis;
atelectasis;
bleeding;
metastases;
pneumofibrosis;
compression syndrome.

Bronchial patency has three degrees of impairment:

1st degree – partial narrowing of the bronchus.
2nd degree – valvular narrowing of the bronchus.
3rd degree – occlusion (impaired patency) of the bronchus.

Symptoms of the tumor may not be observed for a long time. The absence of symptoms is most likely with peripheral tumors. Depending on the severity of the symptoms, several stages of the pathology are distinguished.

Stages of formations

Stage 1. It is asymptomatic. At this stage, partial narrowing of the bronchus occurs. Patients may experience a cough with a small amount sputum. Hemoptysis is rare. During examination X-ray does not detect anomalies. Tests such as bronchography, bronchoscopy, and computed tomography can show the tumor.

Stage 2. Valve narrowing of the bronchus is observed. At this point, the lumen of the bronchus is practically closed by the formation, but the elasticity of the walls is not impaired. When you inhale, the lumen partially opens, and when you exhale, it closes with the tumor. In the area of the lung that is ventilated by the bronchus, expiratory emphysema develops. As a result of the presence of bloody impurities in the sputum and swelling of the mucous membrane, complete obstruction (impaired patency) of the lung may occur. Inflammatory processes may develop in the lung tissues. The second stage is characterized by a cough with the release of mucous sputum (pus is often present), hemoptysis, shortness of breath, increased fatigue, weakness, chest pain, fever (due to the inflammatory process). The second stage is characterized by alternation of symptoms and their temporary disappearance (with treatment). An X-ray image shows impaired ventilation, the presence of an inflammatory process in a segment, lobe of the lung, or an entire organ.

To be able to make an accurate diagnosis, bronchography, computed tomography, and linear tomography are required.

Stage 3. Complete obstruction of the bronchial tube occurs, suppuration develops, and irreversible changes in lung tissue and their death occur. At this stage, the disease has such manifestations as impaired breathing (shortness of breath, suffocation), general weakness, excessive sweating, chest pain, elevated body temperature, cough with purulent sputum (often with bloody particles). Sometimes pulmonary hemorrhage may occur. During examination, an x-ray may show atelectasis (partial or complete), inflammatory processes with purulent-destructive changes, bronchiectasis, extensive education in the lungs. To clarify the diagnosis, a more detailed study is necessary.

Symptoms

Symptoms of low-quality tumors also vary depending on the size, location of the tumor, the size of the bronchial lumen, the presence of various complications, and metastases. The most common complications include atelectasis and pneumonia.

In the initial stages of development, malignant cavity formations, originating in the lungs, show few signs. The patient may experience the following symptoms:

general weakness, which intensifies as the disease progresses;
increased body temperature;
fast fatiguability;
general malaise.

Symptoms initial stage development of neoplasms are similar to signs of pneumonia, acute respiratory viral infections, bronchitis.

The progression of a malignant formation is accompanied by symptoms such as cough with sputum consisting of mucus and pus, hemoptysis, shortness of breath, and suffocation. When the tumor grows into the vessels, pulmonary hemorrhage occurs.

A peripheral lung mass may not show signs until it invades the pleura or chest wall. After this, the main symptom is pain in the lungs that occurs when inhaling.

On late stages malignant tumors appear:

increased constant weakness;
weight loss;
cachexia (depletion of the body);
the occurrence of hemorrhagic pleurisy.

Diagnostics

To detect tumors, the following examination methods are used:

Fluorography. Prophylactic diagnostic method x-ray diagnostics, which allows you to identify many pathological formations in the lungs. read this article.
Plain radiography of the lungs. Allows you to identify spherical formations in the lungs that have a round outline. An x-ray image reveals changes in the parenchyma of the examined lungs on the right, left or both sides.
CT scan. Using this diagnostic method, the lung parenchyma is examined, pathological changes lungs, each intrathoracic lymph node. This study prescribed when needed differential diagnosis round formations with metastases, vascular tumors, peripheral cancer. Computed tomography allows a more accurate diagnosis to be made than x-ray examination.
Bronchoscopy. This method allows you to examine the tumor and perform a biopsy for further cytological examination.
Angiopulmonography. It involves performing invasive radiography of blood vessels using a contrast agent to detect vascular tumors of the lung.
Magnetic resonance imaging. This diagnostic method is used in severe cases for additional diagnostics.
Pleural puncture. Study in the pleural cavity with a peripheral tumor location.
Cytological examination of sputum. Helps determine availability primary tumor, as well as the appearance of metastases in the lungs.
Thoracoscopy. It is carried out to determine the operability of a malignant tumor.

Fluorography.

Bronchoscopy.

Angiopulmonography.

Magnetic resonance imaging.

Pleural puncture.

Cytological examination of sputum.

Thoracoscopy.

It is believed that benign focal formations of the lungs are no more than 4 cm in size, larger focal changes talk about malignancy.

Treatment

All neoplasms are subject to operative method treatment. Benign tumors must be immediately removed after diagnosis in order to avoid an increase in the area of affected tissue, trauma from surgery, the development of complications, metastases and malignancy. At malignant tumors and benign complications may require a lobectomy or bilobectomy to remove a lobe of the lung. With the progression of irreversible processes, a pneumonectomy is performed - removal of the lung and surrounding lymph nodes.

Bronchial resection.

Central cavity formations localized in the lungs are removed by resection of the bronchus without affecting the lung tissue. With such localization, removal can be done endoscopically. To remove tumors with a narrow base, a fenestrated resection of the bronchial wall is performed, and for tumors with a wide base, a circular resection of the bronchus is performed.

For peripheral tumors, surgical treatment methods such as enucleation, marginal or segmental resection are used. For large tumors, lobectomy is used.

Lung formations are removed using thoracoscopy, thoracotomy and videothoracoscopy. During the operation, a biopsy is performed, and the resulting material is sent for histological examination.

For malignant tumors, surgical intervention is not performed in the following cases:

when it is not possible complete removal neoplasms;
metastases are located at a distance;
impaired functioning of the liver, kidneys, heart, lungs;
The patient's age is more than 75 years.

After removal of the malignant tumor, the patient undergoes chemotherapy or radiation therapy. In many cases, these methods are combined.