There are no two identical leaves on Earth, and no identical lung tumors.
A strange thing happened to this middle-aged lady, fortunately it was a good thing!
She is 41 years old this year. She had a cold after catching a cold. She coughed and coughed up sputum for a month, but it did not improve on and off. Later, she even developed blood in the sputum.
Blood in adult sputum is often a red flag.
So I quickly went to the hospital for a CT scan. Sure enough, I found a 4.0cm soft tissue mass in the left hilar area, with a slightly segmented edge, and the enhanced scan showed uneven enhancement (the picture on the right is the enhanced CT scan. ).
Trouble!
In hospital, a puncture was performed, and the doctor found abnormal cells in the punctured tumor tissue, suggesting lung adenocarcinoma.
Fortunately, no major blood vessels were involved, no mediastinal pleura was damaged, and no lymph node metastasis was found. After consultation with the thoracic surgeon, it was considered that it could be removed.
So I went to the thoracic surgery department for a minimally invasive surgical resection. As a result, another accident happened!
Postoperative pathological analysis, the pathologist cut the tumor tissue into sections, put it under the microscope and searched over and over again, but no cancer cells were found.
Immunohistochemistry was performed later, and it was revealed that the pathology turned out to be a benign tumor: Sclerosing Pneumocytic Tumor (PSP).
Not lung cancer! good guy!
The red area on the right is a vascular lake (hemangioma-like area)
What is this all about? Where do the cancer cells found before surgery go? From good? Reformed?
Hi, this tumor is a pit!
This is a rare benign tumor, more common in women, that contains 4 components: hemangioma-like, papillary, solid, and fibrotic.
The tumor cells in the papillary area are often slightly enlarged (above), have atypia, and look very similar to cancer cells. There are too few preoperative biopsy specimens, and sometimes it is impossible to distinguish the lung glands. Papillary growths of carcinoma and papillary areas of sclerosing pneumocyoma can be mistaken for moderately differentiated lung adenocarcinoma.
And the hemangioma-like areas in the tumor are like blood vessel lakes, which show obvious uneven enhancement during enhanced scanning, and are also easily confused with lung cancer (at this time, pay attention to delayed scanning and measurement of CT values).
This patient was diagnosed as a benign tumor, PSP, by means of a large specimen after surgical resection combined with immunohistochemistry.
How many misdiagnoses are caused by puncture of this type of tumor?
According to some doctors, the chance of misdiagnosing this benign tumor as lung adenocarcinoma by preoperative puncture can even reach 25%.
Since it is a benign tumor, can it be done without surgery? Is it a slap in the face?
Some people may think that it is a bit unfair to take a knife for a benign tumor, and it will cost tens of thousands of dollars.
Is it okay to not have surgery?
Surgery can be beneficial. Because of the malignant potential of this tumor, there is a potential risk of progression to lung cancer.
The tumor cells in the papillary area are like swinging people, thinking of heaven and hell.
This is another 41-year-old woman who has coughed and coughed up a small amount of blood for 3 days. CT revealed a left lung mass with a translucent halo sign (tumor hemorrhage) around it.
Preoperative consultation suspect classcarcinoma (a neuroendocrine carcinoma), the surgical pathology was benign sclerosing pneumocytic tumor (PSP).
It will not be malignant if it is removed.
I am Dr. Imaging Kehao, welcome to follow!