Diagnosis and treatment of benign solitary tumor of the lung

Authors

Keywords:

solitary pulmonary nodules, benign tumor, diagnostics, treatment.

Abstract

Background. Solitary pulmonary nodules are common problem in everyday clinical practice, which is largely due to the development and improvement of modern radiological research methods and the widespread introduction of high-resolution computed tomography of the thorax. The earliest possible differential diagnosis of benign and malignant tumors, as well as the development of rational medical approaches to the treatment of such patients is the main importance. The article presents the features of the diagnosis of single benign lung tumors and their treatment. Objective – retrospective analysis of diagnostics and reatment in benign tumor solitary pulmonary nodules. Methods. The study group consisted of 74 in-patients with benign lung tumors at State organization «National institute of phthisiology and pulmonology named after F. G. Yanovsky NAMS of Ukraine» over a 5-year period, 81 nodules were identified. In each case, the number of formations in the lungs did not exceed three, and their size was £ 3 cm. The localization, shape and size of formations were determined. The variants of diagnostic and therapeutic procedures that were used in the clinic with the results of morphological diagnostics are presented. As well as measures for further medical support of patients are described. Results. At the time of hospitalization, in 54 (72,9 %) cases, the etiology of solitary lung nodules was not determined, the majority of solitary benign lung tumors were revealed incidentally (44 cases, 59,5 %). It was found that benign lung tumors were most often represented by one nodule (69 cases, 93,2 %). In most cases, the nodules were localized in the lower lung lobes (22, 27,2 % on the right and 18, 21,0 % on the left, a total of 40 nodes, 49,4 %). The size of the nodules was within 11-20 mm in 44 (54,3 %) cases and rounded shape was in 64 (79,0 %) cases. The most common tactic for inpatient medical management of patients with benign tumors was the simultaneous establishment of an histological diagnosis and surgical treatment (68 cases, 71,9 %). In morphological examination, hamartochondroma of the lung was diagnosed more often (70 cases, 94,6 %). As a result of the diagnostic and treatment, the etiology of formations was established in 72 out of 74 (97,3 %) cases. Conclusion. In most cases, it is not possible to establish the etiology of single benign lung tumors only by radiological examination. A localization in the lower lung lobes is common. The most typical medical tactic in a hospital is the radical surgical removal of such nodules with its morphological verification. It has been established that almost all such formations are hamartomas (mainly hamartochondromas).

References

  1. Ost DE, Gould MK. Decision making in patients with pulmonary nodules. Am J Respir Crit Care Med. 2012;185(4):363–372. DOI: 10.1164/rccm.201104-0679CI.
  2. Porhanov VA, SHul'zhenko LV, Polyakov IS, Bolotova EV, Smolin AA. [Diagnosis of solitary pulmonary nodules and patients follow-up strategy]. Kazan medical journal. 2016;97(5):736–743. Russian. DOI: 10.17750/KMJ2016-736.
  3. Weinberger SE. Diagnostic evaluation and management of the solitary pulmonary nodule. UpToDate. 2015. Available from: http://www.uptodate.com/contents/diagnostic-evaluation-and-management-of-the-solitarypulmonary-nodule.
  4. Liu B, Chi W, Li X, Li P, Liang W, Liu H, Wang W, He J. Evolving the pulmonary nodules diagnosis from classical approaches to deep learning‑aided decision support: three decades’ development course and future prospect. Journal of Cancer Research and Clinical Oncology. 2020;146(1):153-185. DOI: 10.1007/s00432-019-03098-5.
  5. Brandman S, Ko J. Pulmonary nodule detection, characterization, and management with multidetector computed tomography. J Thor Imag. 2011;26(2):90–105. DOI: 10.1097/rti.0b013e31821639a9.
  6. Vynnychenko ІО, Moskalenko YuV, Serdyuk МYu, Vynnychenko ОІ. [Peculiarities of differential diagnosis of benign pulmonary tumors and its significance for the surgical tactics choosing]. Klinichna khirurhiia. 2018;85(4):67–70. Ukrainian. DOI: 10.26779/2522 1396.2018.04.67.
  7. Ost D, Fein AM, Feinsilver SH. Clinical practice. The solitary pulmonary nodule. N Engl J Med. 2003;348:2535-2542.
  8. Callister ME, Baldwin DR, Akram AR, Barnard S, Cane P, Draffan J, Franks K, Gleeson F, Graham R, Malhotra P, Prokop M, Rodger K, Subesinghe M, Waller D, Woolhouse I. British Thoracic Society guidelines for the investigation and management of pulmonary nodules. Thorax. 2015;70(12):1-54. DOI: 10.1136/thoraxjnl-2015-207168.
  9. Furtado CD, Aguirre DA, Sirlin CB, Dang D, Stamato SK, Lee P, Sani F, Brown MA, Levin DL, Casola G. Whole-body CT screening: spectrum of findings and recommendations in 1192 patients. Radiology. 2005;237(2):385–394. DOI: 10.1148/radiol.2372041741.
  10. Khan T, Usman Y, Abdo T, Chaudry F, Keddissi JI, Youness HA. Diagnosis and management of peripheral lung nodule. Ann Transl Med. 2019;7(15):348.
  11. Wahidi MM, Govert JA, Goudar RK. Evidence for the treatment of patients with pulmonary nodules: when is it lung cancer? ACCP evidence-based clinical practice guidelines. Chest. 2007;132:94–107. DOI: 10.1378/chest.07-1352.
  12. de Hoop B, van Ginneken B, Gietema H, Prokop M. Pulmonary perifissural nodules on CT scans: rapid growth is not a predictor of malignancy. Radiology. 2012;265:611–616. DOI: 10.1148/radiol.12112351.
  13. Siegelman SS, Khouri NF, Scott WW Jr, Leo FP, Hamper UM, Fishman EK, Zerhouni EA. Pulmonary hamartoma: CT findings. Radiology. 1986;160(2):313–317. DOI: 10.1148/radiology.160.2.3726106.
  14. Sugarbaker DJ, Bueno R, Colson YL, Jaklitsch MT, Krasna MJ, Mentzer SJ. Adult Chest Surgery. Hill Education. 2015;1:15-20.
  15. Stevic R, Milenkovic B. Tracheobronchial tumors. J Thorac Dis. 2016;8(11):3401-3413.
  16. Lee HJ, Goo JM, Lee CH, Park CM, Kim KG, Park EAh, Lee HY. Predictive CT findings of malignancy in ground-glass nodules on thin-section chest CT: the effects on radiologist performance. Eur Radiol. 2009;19(3):552-560. DOI: 10.1007/s00330-008-1188-2.
  17. Takashima S, Sone S, Li F, Maruyama Y, Hasegawa M, Kadoya M. Indeterminate solitary pulmonary nodules revealed at population-based CT screening of the lung: using first follow-up diagnostic CT to differentiate benign and malignant lesions. AJR Am J Roentgenol. 2003;180(5):1255–1263. DOI: 10.2214/ajr.180.5.1801255.
  18. Koshak YF. [Diagnostic algorithm and the volume of studies of patients with the suspicion of tuberculosis and lung cancer]. Bulletin of Social Hygiene and Health Protection Organization of Ukraine. 2016;4(70):38–45. Ukrainian.
  19. Shields TW, Locicero III J, Reed CE, Feins RH. General thoracic surgery. Wolters Kluwer. 2009;1:25-27.
  20. Choi SM, Heo EY, Lee J, Park YS, Lee CH, Park CM, Kang CH, Yim JJ, Kim YT, Yoo CG, Han SK, Kim YW. Characteristics of benign solitary pulmonary nodules confirmed by diagnostic video-assisted thoracoscopic surgery. The Clinical Respiratory Journal. 2016;10(2):181-188. DOI: 10.1111/crj.12200.
  21. Davoli F, Lo Faso F, Rossi G, Caruso D, Raulli GD, Stella F. Intrapulmonary solitary fibrous tumour: a rare neoplasm of the lung and a challenging pre-operative diagnosis. Ann Ital Chir. 2019;90:223-267.
  22. Mikubo M, Maruyama R, Kakinuma H, Yoshida T, Satoh Y. Ciliated muconodular papillary tumors of the lung: сytologic features and diagnostic pitfalls in intraoperative examinations. Diagn Cytopathol. 2019;47(7):716-719.
  23. Lapach SN, Chubenko AV, Babich PN. [Statistical methods in biomedical research using Excel]. Morion. 2001;1:350-400. Russian.
  24. Larici AR, Farchione A, Franchi P, Ciliberto M, Cicchetti G, Calandriello L, Del Ciello A, Bonomo L. Lung nodules: size still matters. Eur Respir Rev. 2017;26(146):170025. doi: 10.1183/16000617.0025-2017.

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Published

2022-09-30

How to Cite

Zagaba , L., Liskina , I. ., Melnik, . O., & Kuzovkova, . S. (2022). Diagnosis and treatment of benign solitary tumor of the lung. Морфологія / Morphologia / Morfologìâ, 16(3), 35–44. Retrieved from https://morphology.dma.edu.ua/article/view/281898

Issue

Vol. 16 No. 3 (2022)

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