How far away is the cancer when nodules, polyps, and cysts are examined physically? | doctor's business card

The moment you open the physical examination report, if you see the words nodules, polyps, and cysts, you can't help but "cluck" in your heart.

What exactly are nodules, polyps, cysts?

What is the probability of cancer?

How to deal with it?

Today to send you a full of "dry goods".

Nodules/see whether they are benign or malignant

Nodules are usually small lesions found on computed tomography (CT) or B-timeouts. Although the detection rate of nodules is high, there is no need to be frightened by it, because more than 90% of nodules are benign. And the "bad" nodules that need attention are only a very small part, usually less than 5%.

Common nodules are thyroid nodules, lung nodules, and breast nodules. When these three types of nodules are detected, if the following description is on the physical examination report, it may be a malignant nodule and need to be treated promptly:

01

Thyroid nodules (see neck ultrasound)

The aspect ratio of the nodule exceeds 1;

Low echo or very low echo;

Irregular nodule margins, unclear boundaries;

Gravel calcification;

Abundant blood supply.

02

Lung nodules (see CT of the lungs)

In general, people who are older, have underlying diseases in the lungs or are heavy smokers, and it is easy to find lung nodules when they are examined.

upper lobe nodules of the lungs (nodules in the upper lobes of the lungs are more likely to be malignant than those in the lower or middle lobes of the lungs);

Nodule size>8 mm;

Uneven density of nodules;

The shape of the nodules is ground glass, especially those with solid components;

The edges of the nodules are not smooth, with burrs or lobes;

The nodules gradually increase or increase in density, or the solid composition increases.

03

Breast nodules (see breast B ultrasound/molybdenum target)

Irregular morphology and unclear boundaries;

Marginal burrs or crab feet;

Aspect ratio greater than 1;

Clustered fine calcifications;

Rear attenuation.

Doctor reminds

Patients who have been diagnosed with benign nodules only need regular follow-up. In addition, regular follow-up examinations are recommended to be done in the same hospital so that doctors can compare the dynamic changes of the nodules.

Polyps/benigns are the majority

Polyps are a piece of tissue that grows on the surface of the body's mucosa and is often discovered during endoscopy. Gastric polyps, intestinal polyps, gallbladder polyps, and nasal polyps are more common.

If stomach polyps or intestinal polyps are found, they are usually cut off directly by surgery, and then the "meat pieces" cut off are subjected to pathological examination, and the good and malignant nature of the polyps is judged according to its microscopic morphology.

In pathological reports, polyps are divided into these categories:

People with high-risk adenomatous polyps or people with a family history of bowel cancer are recommended to follow up more intensively, and insist on regular colonoscopy, early detection and early treatment.

Cysts / basically do not require treatment

A cyst is a complete wall of the capsule filled with liquid substances, which we can also think of as a "small blister".

The most common cysts reported on the physical examination are ovarian cysts, liver cysts, and kidney cysts, and different cysts are detected with different coping strategies:

Ovarian cyst

A distinction needs to be made between physiological cysts and pathological cysts.

Physiological: related to the menstrual cycle, the appearance and disappearance of cysts appear cyclical and do not require treatment.

Pathological: when the size of the cyst exceeds 5 cm; there are corresponding symptoms, such as low back pain, etc. You need to go to the hospital for further medical attention to determine whether surgery or puncture drainage of the cyst is required. Its greatest danger is that if it is reversed or ruptured, it will cause ischemic necrosis and secondary infection.

Liver cysts

The probability of malignancy in a liver cyst is very low, growing on the liver like a small blister. Therefore, if the cyst has no symptoms, and 3 to 6 months, the volume does not grow significantly, only need to follow up regularly.

Kidney cysts

For simple renal cysts, regular follow-up is fine if there are no symptoms.

For polycystic kidneys that affect renal function, aggressive treatment is required.

Small cysts are not terrible, and regular physical examinations can be performed in the same hospital; symptomatic cysts need to be treated in time to the corresponding specialty.

Author | Li Jianjun, deputy chief physician of the Department of Oncology, Southwest Hospital of the Army Military Medical University

Audit | Expert of the National Health Science Popularization Expert Database

Liang Houjie, chief physician of the Department of Oncology, Southwest Hospital of the Army Military Medical University

Planning | Tan Jia

Edit | Liu Yang