Rare case: chest CT examination in January showed micronodule, which grew to 2cm in August with systemic metastasis

This patient was sent to me by a colleague. I transferred his film to see it in our hospital. The film from August was opened first, and I saw it in the upper lobe of the right lung. A 2cm tumor had metastasized to bone, and I transferred out his January film and took a closer look. There was a very inconspicuous nodule less than 3mm in the area where the 2cm tumor had grown. It was done in our hospital. Bronchoscopy has confirmed the diagnosis of poorly differentiated small cell lung cancer.

Small cell lung cancer is a highly malignant lung cancer that can grow in size in a short period of time. It takes as little as 60 days to double in size. It appears as a solid nodule at the same time. For example, when this patient showed a 3mm nodule on the film in January, it was already a solid nodule. Another feature of small cell lung cancer is that small lesions have large metastases, that is, the lesions are very large. When he was young, the metastases were very large, even larger than the parent lesions. This characteristic of this patient was also obvious. The size of the mediastinal lymph nodes was almost the same as that of the lung lesions.

Of course, you don’t need to panic too much, this case is too rare, and today I feel that my understanding of nodules has been refreshed. I have never seen such small cells growing so fast before. For lung cancer, most patients with pulmonary nodules are safe to re-examine in three to six months when they are first discovered, and generally do not lose the chance of radical cure.