Detection of a tumor in the lungs always scares a person, because the first thing that comes to mind is cancer. But among the neoplasms of the lower respiratory tract, there are also benign - dangerous, but potentially curable.
The risk of the degeneration of such tumors into cancer exists, so they need to be treated at the earliest stages. A vivid example of benign lung tumors is a hamartoma, which is dangerous for malignancy or a strong growth in size.
Characteristics of the
disease Lungs of the lung( synonyms - lipochondradenoma, hamartochondroma) - neoplasm of the congenital nature that is not malignant, located in the respiratory system, consists of both normal lung tissue and various abnormal inclusions.
Inside the tumor there are blood vessels, that is, it is supplied with blood and is fed by dissolved substances in the blood.
Photo of hamartoma lung
Lung formation is located in the organ parenchyma. As a rule, its dimensions are small - about 2-6 cm, and, as the tendency to a rapid increase in size or germination in neighboring areas( metastasis), it does not differ, a person can live a lifetime without knowing about his illness.
On the neighboring systems and organs the disease also does not affect, in the form of multiple formations appears rarely.
Despite this, oncology recorded a certain number of clinical cases in which the tumor slowly but surely grew, led to the emergence of a giant neoplasm that does not allow easy to function normally.
Another danger of pathology is the risk of its degeneration into cancer, which happens in about 5-7% of situations.
As for medstatistics, the overwhelming majority of non-cancerous respiratory system tumors are precisely hamartomas( more than 65%).In boys and men, they appear more often. Prevalence in the general population is not higher than 0.3%.The average age of diagnosis of this tumor is 50 years, most often it is detected in 40-70 years.
Localization of the tumor remains on the periphery in the anterior parts of the lung, mainly in the right lung. Very rarely, 2-3 tumors are recorded in two respiratory organs.
In the latter case, a thorough examination should be carried out for the presence of congenital pathologies with the formation of benign neoplasms in all organs and tissues.
The following are the main pathophysiological characteristics of the tumor:
- Appearance - node in the capsule, either without it, but clearly limited from healthy tissue
- Color in the section - gray, yellowish
- Consistency - tightly elastic
- Structure - lobules with fibrous interlayers
- Surface -smooth or with small mounds
- Size - 1-12 cm, average diameter 5 cm.
- Composition - cartilaginous, fatty, connective, smooth muscle, glandular tissue, vessels, lymphatic cells
- Inclusions - bony, limes, kistoobraznye
reasons
pathology Until recently the question of why some people get lung hamartoma, had only one answer.
It was believed that the tumor is formed due to malfunctions at any stage of the laying of the respiratory system in the fetus. Like heart defects, hamartoma was recognized as a sign of imperfection of the processes taking place in the body of the embryo - mainly, in the first weeks after conception.
This theory was confirmed by the fact that almost all the tissue components of the tumor have origin from the embryonic tissue.
Recently, it has been suggested that the disease can occur during life against the background of the existing predisposition. This idea leads to the presence in the tumor of a large part of normal lung tissue.
But most experts still consider the disease the result of failures of embryogenesis and appearance in the lungs of a site whose components are identical to normal tissues, but their location and differentiation is incorrect.
There are several pathogenic factors that, presumably, can affect the failure in embryogenesis:
- Burden of heredity
- Mutations of chromosomes
- Exposure to the mother and fetus of radiation
- Poisoning, intoxication
- Taking drugs with teratogenic effect
Factors that cause growth of a hamartoma during life are not yet established. Since it is not found immediately after birth, but much later, while the growth rates in different patients are not the same, it is recognized as an individual feature of the body. Data on the involvement of smoking in this fact are absent.
Classification of
There are several classifications that differ in the sign of differentiation of tumors. Based on the prevalence of neoplasm composition, the classification is as follows:
- Fatty.
- Fibrous.
- Angiomatous.
- Chondromatous.
- Leiomyomatous.
- Mixed.
The unit for multiple and single neoplasms is based on the amount of their presence in the lung tissue. In the overwhelming majority of cases, only one tumor is detected.
Classification by area of education is as follows:
- Endomobronchial - located in the bronchus.
- Intrapulmonary - captures the parenchyma( the main tissue) of the organ, can be localized in the basal, cortical, median zone.
- Subpleural - is on the surface, more often - in the region of the apex of the lung.
Symptoms and manifestations of
The clinical picture largely depends on the location and size of the tumor. It is important and overlapping of large bronchi, touching the chest walls, diaphragm.
If the neoplasm is located on the periphery of the lung, its clinic is meager or absent. Small size( up to 3 cm) is also an indicator that the symptoms of the disease will not appear. Only an unfavorable location or active growth of a tumor in diameter and compression of its lung and bronchial tissue leads to the formation of a clinical picture.
Symptom complex of the disease is not specific, so only further diagnosis can confirm the doctor's fears.
The main symptoms can be as follows:
- Pain or chest discomfort that is localized
- Strengthening painfulness( aching, stitching) with deep inspiration
- Bronchial obstruction and shortness of breath
- Frequent, regular coughing or slight coughing
- Isolation atcoughing of mucous or yellowish sputum
- Rarely - hemoptysis, mainly with severe physical overload
If a benign tumor completely blocks the bronchus, it will lead to the development of obtuation of the lung with pneumonia. A person in this case has a clinic of the infectious process, which can lead to errors in diagnosis.
In general, the degree of severity of the disease clinic is divided as follows:
- The first degree is the absence of symptoms.
- The second degree is a small manifestation.
- Third degree - squeezing of the lungs and the emergence of severe symptoms.
Diagnostics
Instrumental methods are important for setting a preliminary diagnosis. The simplest, but effective - radiography of the lungs.
In recent years, this study is often replaced by an MRI or CT scan, which is expensive, but provides more accurate information.
According to the picture, the tumor is seen as a small shadow with clear contours, and on the sides it is surrounded by a normal pulmonary tissue without changes.
A slight tuberosity of the tumor may be noticeable. The intensity and brightness of the shadow are determined by the number of dense inclusions.
If the neoplasm has grown to an impressive size, then in the tissues of the respiratory organs the vascular pattern is strengthened.
If the location of the tumor allows you to take it for analysis using bronchoscopy, this method should also be used in diagnosis. During a bronchoscopy, take a piece of the tumor( biopsy), after which it is carefully examined.
In other situations, such a survey does not make sense, and to confirm the diagnosis and differentiation of the disease with lung cancer, transthoracic biopsy with subsequent histological examination of the material is necessary.
Further regular examinations are required to clarify the nature of tumor growth.
It is usually of low intensity. Mandatory disease is differentiated from lung cancer, metastases from the chest, genital organs, kidneys, etc., as well as with other benign neoplasms.
Treatment of a hamartoma of the lung
Under the supervision of a pulmonologist, small formations may be located that do not have a tendency to grow. Their size should not exceed 3 cm. Medications in this case do not apply, but it is recommended to give up smoking to maintain lung health.
In the presence of the symptoms described above, bronchodilators, expectorants, antitussives and other medications are used prior to surgery.
Treatment of large and disturbing human tumors, as well as growing neoplasms only operative. Gamartoma is removed after opening the chest, or in a minimally invasive way - with punctures and the introduction of video equipment.
The following operating procedures are used( as indicated):
- Nodule excision
- Partial resection of the lung
- Excision of the lobe of the
- Bronchotomy with tumor removal
- Resection of the bronchus with defect plastic
To accurately exclude cancer, tumor research is performed right during the operation after removal. If necessary, further specific treatment of cancer is prescribed.
Prognosis and prevention of complications
Usually, the pathology does not progress, or its development is very slow. Transition to a cancerous tumor occurs rarely( less than 7%).In this case, the tumor grows rapidly, metastasizes to the liver, diaphragm, spine.
To prevent complications, you need to do fluorography once a year, constantly monitoring the tumor. If it does not change in size, radical treatment may not be necessary at all. When the onset of disease progression is important, it is important to remove the tumor in time in order to avoid consequences.