When I went out of the clinic on Wednesday, a 42-year-old civil servant patient came and a physical examination found a lung nodule. The patient reported that a 2 cm lung nodule was found on physical examination. I asked the patient how long it had been since he had noticed. The patient told me that this was the first time that it was discovered, and that in the past, the physical examination was all chest X-ray, and no abnormalities were found in the annual physical examination, but this year's unit physical examination was changed to a low-dose thin-slice CT examination, and the physical examination reported that there was a mixed ground-glass nodule in the upper lobe of the right lung.
I looked at her CT** and there was a lung nodule about 2 cm in diameter in the upper lobe of the right lung, which was a mixed density ground-glass nodule.
I told the patient and his family that the pulmonary nodule was a mixed density nodule with a diameter of much more than 5 mm, lobulation sign, vacuolar sign, vascular bundle sign, and the possibility of malignancy was high, and surgery was recommended**.
After careful consideration, the patient and his family agreed to the operation, and the hospital underwent a preoperative examination.
After admission, the relevant examinations were completed, and there were no obvious contraindications to surgery, and the right upper lobe resection + systematic lymph node dissection was performed under general anesthesia under thoracoscopic resection. Anti-inflammatory, phlegm-reducing and analgesic** were given after surgery, and the patient recovered well. The patient was instructed to move to the ground as early as possible, actively cough and discharge sputum, and on the third day after surgery, there was less thoracostomy drainage, there was no abnormality in chest x-ray, and the patient was safely discharged.
The results of postoperative examination showed that there was microinvasive adenocarcinoma of the right upper lung without lymph node metastasis.
Later, the patient's family came to ** to consult the medical examination and prognosis, and I told the family about the medical examination and added: the patient does not need chemotherapy, targeted ** and other adjuvants after surgery**, and regular re-examination is sufficient.
Lung cancer is the most common cancer in China, and adenocarcinoma is the most common pathological type, accounting for about 60%. Adenocarcinoma is divided into carcinoma in situ, minimally invasive carcinoma, and invasive carcinoma according to the degree of invasion.
According to the latest relevant research data, the 5-year survival rate of carcinoma in situ and minimally invasive cancer is high and the prognosis is good.
Mixed-density nodules are pure ground-glass nodules with solid components that can mask vascular imaging. The study found that if the promiscuous density nodule is microinvasive or invasive lung cancer, the general solid component represents the depth of invasion of the nodule. The solid component of the pulmonary nodules in this patient was less than 5 mm, and the postoperative examination showed microinvasive carcinoma, which also verified the results of this study.
The patient had chest X-ray every year and found no abnormalities, but a chest CT showed a lung nodule of about 2 cm. This suggests that for pulmonary nodules, especially those with ground-glass components, chest CT is far more sensitive than chest x-ray for early detection. The latest Chinese guidelines for the diagnosis and treatment of lung cancer suggest that people aged 45-75 should have a low-dose thin-slice chest CT examination for physical examination every year, which can detect lung nodules early, and some of these lung nodules are lung cancer. After the discovery of pulmonary nodules, it is recommended to find a professional expert who has a certain research on pulmonary nodules for evaluation.
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