Not long ago, a #woman's fingers swollen into radish heads were on the hot search.
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Coincidentally, Dr. Hu Yang recently received a ...
Uncle Yang, who is fifty-five years old this year, coughed for more than half a year, and at first he did not pay much attention to it, until there was an obvious pestle-like situation before he was persuaded by his daughter to go to the hospital for examination. Unsurprisingly, the chest x-ray showed a 5 cm tumor in the lung, which was already in the middle and advanced stages, and the emergency admission was currently undergoing chemotherapy after the diagnosis of the tracheoscopy.
Swollen fingers into radish heads? How are clubbing fingers formed?
The ends of the fingers become enlarged, the fingers or toes become like "pestles", and the ends of the fingers are hypertrophied and become thick, like a drumstick-like finger, which is called a pestle finger in medicine.
We can attach the nail surface of the same finger (usually the middle finger) of both hands to the back of the terminal knuckle together for self-examination. Under normal circumstances, a diamond-shaped window can be formed between the two fingers, but the gap between the clubbing fingers will become smaller and disappear.
It is generally believed that clubbing refers to the lack of oxygen in the end tissues, caused by the opening of the arteriovenous branches of the local microcirculation through the vasoactive substance, resulting in tissue hyperplasia.
Does a clubbing finger necessarily indicate lung cancer? Not necessarily, but may be the first or concomitant symptom of lung cancer
When lung cancer occurs, because airway obstruction can lead to hypoxia, hypoxia in the lungs will then cause tissue hypoxia, and long-term tissue hypoxia will lead to abnormal thickening of the tissues around the ends of the fingers, thus inducing clubbing fingers.
Many patients have developed non-metastatic first extrapulmonary signs and symptoms in the early and middle stages of lung cancer, the most common of which is the clubbing finger. The incidence of clubbing in lung cancer is about 1.6% to 9.4%, in these cases, it is not uncommon to have pestle as the first symptom, especially for middle-aged and elderly patients who smoke for a long time, even if the respiratory symptoms are not obvious, when the clubbing finger is found, it should be paid great attention to so as not to misdiagnose or miss diagnosis.
In addition to lung tumors, you like interstitial lung disease, bronchiectasis, chronic lung abscess are also the most common causes of clubbing.
The cause of the clubbing is only lung disease? The reality is not so simple
Although clubbing is common in lung disease, clinically clubbing is often an early manifestation of some serious diseases, which can occur in all populations, often accompanied by:
Cardiovascular diseases
It is common in some congenital heart disease patients that can cause cyanosis, such as: tetralogy of Fallot, pulmonary venous malformations, subacute endocarditis, chronic congestive heart failure, etc.
Diseases of the digestive system
A few clubbing fingers may be seen in chronic digestive disorders such as malabsorption syndrome, Crohn's disease, and chronic ulcerative colitis.
Disorders of nutritional metabolism
The most common cirrhosis, toxic diseases such as chronic arsenic poisoning, and a small part of the clubbing are genetically related.
For any sign of the body, early detection and early treatment must be key
After the appearance of each disease, the symptoms will not be single, if the clubbing finger is found, it does not mean that there must be a disease, but it is necessary to go to the hospital for examination of related diseases, if it is accompanied by other uncomfortable symptoms, it is more important to pay attention to and treat as soon as possible. You are like Uncle Yang at the beginning, in addition to the pestle finger, he has been coughing intermittently for more than a year, if it is not for the daughter's vigilance, the condition is likely to be delayed.
As the cancer with the highest mortality rate, as far as the clinic is concerned, early lung cancer is not a specific manifestation, some people are dry cough, and then there is coughing up sputum, coughing up blood, chest pain, chest tightness, etc., and there are also dry coughs that start first, follow-up develop into coughing up blood phlegm or hemoptysis, fever symptoms when severe, emaciated body, hoarseness, can appear clubbing fingers can be said to be very "lucky", but not all people have such good luck.
Cancer in the bud often does not have any symptoms, active screening and physical examination is the right way, "early diagnosis, early treatment" is to improve the survival rate of patients, reduce the mortality of patients is the most important, but also the most effective way. Lung cancer screening is simpler than other tumor screening, and low-dose spiral CT of the chest is done conveniently and quickly. For people at high risk of lung cancer, people with a family history of malignant tumors should be actively examined.
Expert Profile Hu Yang
Attending physician of the Department of Respiratory Medicine, Shanghai Pulmonary Hospital affiliated to Tongji University, doctor of medicine, master supervisor. He is a member of the Pulmonary Function Group of the Shanghai Medical Association and a member of the Chinese Medical Association. He specializes in the prevention, diagnosis and treatment of lung diseases such as interstitial lung disease, sarcoidosis, and lung cancer.
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