What are benign lung tumors? Teach you how to identify benign and malignant lung tumors!

It is unfortunate to have a tumor, but if it is a benign tumor, it is a blessing in disguise. For tumors, the difference between malignant and benign is a world of difference. So what are the characteristics of benign tumors in life?

Characteristics of benign lung tumors

It has been reported in China that among nearly 2,000 primary lung tumors confirmed by surgery, approximately 13% were benign tumors. Some benign tumors have cell differentiation and morphology similar to normal cells, grow slowly and do not metastasize; some benign tumors are low-grade malignant tumors and have corresponding malignant clinical manifestations; although some lung lesions have no tumor manifestations pathologically, their clinical and imaging manifestations are similar to tumors, which are called tumor-like changes and are currently also classified as benign tumors.

The clinical manifestations of benign lung tumors are obviously related to the location of the tumor and are not specific. For example, there may be chest tightness, dyspnea, asthma-like symptoms, cough, hemoptysis, etc. Peripheral benign lung tumors are mostly asymptomatic and are usually discovered during physical examinations, while benign tumors within the bronchial lumen often have symptoms, mainly due to partial or complete obstruction of the bronchus, causing recurrent pneumonia, wheezing, hemoptysis, etc.

Classification of benign tumors

Benign tumors can originate from epithelial, mesothelial and other abnormal tissues. Currently, they are mainly classified according to pathological types, see figure.

(1) Pulmonary hamartoma: As the name suggests, pulmonary hamartoma is a tumor-like lesion formed by an abnormal combination of normal tissues in the lung. It is now generally considered to be a congenital malformation. The key word is "normal tissue", so it is a benign thing. Because it does form a "tumor-like lesion", it is called a benign tumor. Hamartoma is the most common benign tumor. Pulmonary hamartomas mainly occur in the lung parenchyma (about 90%), grow slowly, have a long course, and are generally asymptomatic. The lesions are mostly located under the pleura around the lungs. They are round or oval in shape, lobed, of uniform density, with clear and smooth borders. Some lumps are lobed, with multiple small nodules on the edges, and some have flaky calcifications, the typical of which is "popcorn" shaped. CT showed that the mass had shallow lobes, clear boundaries, and no burrs (note the differentiation from lung malignant tumors). The diagnosis is mainly based on imaging examinations, but if it is a bronchial or tracheal hamartoma, fiberoptic bronchoscopy can be used to obtain pathological evidence. Pulmonary hamartoma rarely becomes malignant, but differential diagnosis must be made, so if a lump is found, it still needs to be treated actively, especially for middle-aged and elderly patients.

(2) Inflammatory pseudotumor: Inflammatory pseudotumor is caused by chronic nonspecific inflammation that leads to organizing pneumonia, which then localizes to form a tumor-like mass. It is not a true tumor. It is usually a single solitary lesion, spherical or elliptical, about 3 cm in diameter, with a capsule that is clearly separated from the surrounding normal tissue. Most of the cases are asymptomatic and are often discovered during physical examinations. Some patients may have symptoms of respiratory infection. X-ray monitoring shows a spherical shadow with uniform density, clear edges and complete contours, which is mostly located in the periphery of the lungs and often involves the pleura. It is sometimes difficult to differentiate it from lung cancer clinically.

(3) Bronchial leiomyoma: It is rare in clinical practice and mostly occurs in women. Tumors located in the periphery of the lungs are often asymptomatic. If they occur in the main bronchus or lobar bronchus, cough may occur in the early stages. If the tumor is large, it may cause stenosis of the lumen, or localized wheezing may be heard. Especially when secondary infection occurs, care should be taken to identify it. Bronchial leiomyoma is often difficult to distinguish from lung cancer, so surgical treatment is often recommended, and most patients have a good prognosis after surgery.

Precautions

It is sometimes difficult to differentiate benign from malignant small lung nodules of unknown etiology. The patient can be evaluated based on whether they have high-risk factors for cancer, such as smoking, family history of cancer, chronic lung disease, etc., as well as the diameter and density of the nodules. Close follow-up and invasive procedures or surgical intervention may be performed if necessary.

The principles for the treatment of benign lung tumors are: if pathologically confirmed to be benign, with no clinical manifestations and no malignant tendency, the patient can survive with the tumor and be followed up regularly; once clinical symptoms and signs appear and there is a malignant tendency, surgical resection should be considered. Certain benign tumors growing in the wall or lumen of the trachea or bronchus can be treated with bronchoscopic laser cauterization, freezing, argon gas knife, etc., and can be removed by thoracotomy if necessary.