Some of us feel apprehensive or at least a bit worried when entering the doctor’s office. Hearing the word cancer or tumor prompts very negative connotations, and we could even stop listening to whatever the doctor is saying, overwhelmed by fear.
But a tumor is not the same as cancer, and different tumors can develop in the lung. In this article, we’re covering essential tumors and nodules of the lung. Are they the same as lung cancer, or do they carry any particular risk?
Is It Lung Cancer?
The diagnosis of lung cancer is not that simple. Even if you have a suspicious image in an exam, it is not cancer until it is properly analyzed. The words nodule and tumor are used interchangeably to refer to an image that has not been diagnosed yet. Some of them will be benign tumors. Others will be malignant tumors or cancer. The adjective is only given after a proper diagnosis and exams are performed.
Then, what is a nodule? It is a spot found in imaging tests, usually X-rays or a CT scan. They are very common and often rounded and solid. It can be only one nodule or multiple lesions in the lung.
Many patients have had this type of nodule in the lungs and feel stressed and worried about it only to find out that it is a harmless problem and it won’t turn into cancer. But is there a way to tell benign lesions apart?
How To Recognize a benign Lung Nodules ?
If a nodule was found in your lung, it is more likely to be benign, especially if you’re a young patient, because lung cancer is only common in the elderly or at least after 40 years. If you do not smoke and have not smoked for the last ten years, cancer risk is even lower. More than that, specific characteristics of the nodule give out clues of a benign nature, especially a small size and the presence of calcium (calcified borders or interior).
Benign nodules are usually asymptomatic. Were it not for this image in the X-rays, you wouldn’t even suspect that something is there in your lungs. Most of them are found by chance when you take an imaging test for any other reason. However, some patients with benign lung nodules have symptoms such as shortness of breath, fever, and coughing. Sometimes they could even cough up blood, and this is not always a sign of cancer.
If these lesions can have cancer-like symptoms and look like cancer, how does the doctor diagnose benign tumors? If you have a very small nodule, one of the approaches could be watching the nodule after repeating the X-rays. A nodule that remains the same size after one or two years is not likely cancer. In some cases, the nodules grow but very slowly. In contrast, cancer tends to proliferate and doubles its size after a few months.
However, this “watch and see” approach may not be appropriate for everyone. It is definitely not a good idea if you have a high risk of cancer (mainly due to advanced age and chronic smoking habits). Thus, additional studies are performed on these patients. The doctor would examine the edges of the nodule, the shape and look for calcifications. Other tests and tumoral markers may be recommended to identify malignant nodules. The doctor may also decide to perform a tuberculosis test because this is a common cause of nodules in the lungs.
In highly suspicious nodules and high-risk patients, a biopsy will be performed. This is an aspirate of cells through a bronchoscopy or using a needle to examine the sample under the microscope. After a close examination, doctors would confirm if the tumor is benign or not.
Common Causes Of benign Nodules In The Lungs
Nodules in the lungs can grow for different causes, and some are not always diagnosed and understood. However, the most common causes are as follows:
- Infections and inflammation: Tuberculosis is one of the most common infections that cause nodules in the lungs. Others include histoplasmosis, aspergillosis, cryptococcosis, and coccidioidomycosis. In most cases, the immune system tries to destroy the bacteria and causes damage to the lung in the process.
- Lung abscess: An abscess is a collection of pus and debris. They are usually formed as a result of chronic infection. The body encapsulates this infection, causing a round figure in the X-rays.
- Rheumatoid arthritis nodules: This is not a common manifestation of rheumatoid arthritis, but it is still possible. These lesions are usually asymptomatic and more common in patients who use methotrexate.
- Wegener granulomatosis: Wegener’s lung nodules usually measure 2-4 centimeters, but larger nodules can also be found. In most cases, there is more than one nodule, and they are found in both lungs.
- Sarcoidosis: It is often a solitary lung nodule and is commonly mistaken for cancer. This is an inflammatory disease that affects the lymph glands and the lungs.
- Hamartoma: This is also a prevalent cause of solitary lung nodules. But they are filled with lung tissue and not cancerous. In most cases, hamartomas are found in the borders of the lungs, away from the center.
- Bronchial adenoma: Around half of benign tumors in the lungs are diagnosed as bronchial adenomas. They are growths of tissue, but they are not malignant. They develop in the ducts and mucous glands of the airways.
- Fibroma or lipoma: These tumors are not as common as the others on the list
- Lung cysts and birth defects: A cyst is a lesion filled with liquid. This and other types of lesions can be found as birth defects.
Treating benign Tumors In The Lungs
Benign tumors in the lungs do not require aggressive treatment as cancer does. Some of them are not treated at all. Instead, doctors decide to watch the nodule and take new imaging tests after a while to compare.
Depending on the case, the doctor may recommend taking a biopsy or removing the tumor entirely. After a benign nodule in the lungs is diagnosed, your treatment will be limited to the underlying disease. For example, if you have tuberculosis or pneumonia, you will likely need a round of antibiotics.
References:
Ohtsuka, T., Nomori, H., Horio, H., Naruke, T., & Suemasu, K. (2003). Radiological examination for peripheral lung cancers and benign nodules less than 10 mm. Lung Cancer, 42(3), 291-296.
Zhang, G., Yang, Z., Gong, L., Jiang, S., & Wang, L. (2019). Classification of benign and malignant lung nodules from CT images based on hybrid features. Physics in Medicine & Biology, 64(12), 125011.
Loverdos, K., Fotiadis, A., Kontogianni, C., Iliopoulou, M., & Gaga, M. (2019). Lung nodules: A comprehensive review on current approach and management. Annals of thoracic medicine, 14(4), 226.
Pabón Páramo, C. A., Antúnez Oliva, J. A., & Montero Brenes, F. F. (2020). Solitary pulmonary nodule: radiological characterization. Revista Médica Sinergia, 5(03), 399-399.
