Early lung cancer should be differentiated from lung inflammation

Lung inflammation that needs to be differentiated from early lung cancer includes:

(1) Bronchopneumonia: Obstructive pneumonia caused by early lung cancer is easily misdiagnosed as bronchopneumonia. Bronchopneumonia has an acute onset, usually with chills, high fever, body aches and other bloody symptoms, followed by respiratory symptoms. Antimicrobial treatment is very effective, and the lesions are absorbed quickly and completely. The inflammation of cancerous obstructive pneumonia is absorbed more slowly, or block shadows appear after the inflammation is absorbed, and most of them are manifestations of central lung cancer. Bronchoscopy and cytology are helpful for differentiation.

(2) Lung abscess: When the central part of lung cancer necrotizes and liquefies to form a cancerous cavity, the X-ray signs are easily confused with lung abscess. Cases of lung abscess often have a history of aspiration pneumonia, and the onset is relatively rapid. In the acute phase, there are obvious symptoms of infection, often with chills, high fever, cough, sore throat, coughing up a lot of purulent sputum, and high total white blood cell counts and neutrophil counts in peripheral blood. The cavity wall is thin on the X-ray film, the inner wall is smooth, and there is a fluid level. The lung tissue or pleura around the abscess often has inflammatory lesions. During bronchography, contrast agents can enter the cavity and are often accompanied by bronchiectasis. Cancerous cavities often first have symptoms of tumors such as coughing, hemoptysis, and physical weakness, and then symptoms of secondary infection such as coughing up purulent sputum and fever appear. Chest X-rays show that the shadow of the cancerous mass has an eccentric cavity with thick walls and a relatively uneven inner wall. It can be distinguished by combining bronchoscopy and sputum exfoliated cell examination.

(3) Inflammatory pseudotumor: Inflammatory pseudotumor is a tumor-like proliferative lesion in the lung caused by nonspecific inflammation. It often occurs in people under 40 years old, more often in women than in men. It is usually asymptomatic, but may also have blood in sputum. Clinically, low-grade fever and chest pain may occur. On CT, inflammatory pseudotumor is generally shallowly lobed, with long spurs as the main feature. A few may have pleural indentation, but most have clear edges and may have calcification. Enhanced scanning has obvious enhancement. Lung cancer lobes are often deep, with spurs of varying lengths. Short spurs are more significant signs. There may be a thin ring-shaped shadow of increased density at the periphery, called the halo sign, which is a manifestation of tumor infiltration to the periphery. There is low-density necrosis in the center, and there may be pleural indentation. There are no satellite lesions. Some of them can be seen to be closely related to an adjacent bronchus. Calcification is relatively rare, and enhanced scanning has moderate enhancement.