What is costochondritis. How does it differ from Tietze syndrome. What causes costochondritis. What are the symptoms of costochondritis. How is costochondritis diagnosed. What are the treatment options for costochondritis. How can costochondritis be prevented.

Understanding Costochondritis: A Common Cause of Chest Pain

Costochondritis is a condition characterized by inflammation of the costochondral junctions, which are the areas where the upper ribs connect to the cartilage that attaches them to the breastbone (sternum). This condition is a frequent source of chest discomfort, particularly in children and adolescents. Despite its alarming symptoms, costochondritis is generally harmless and often resolves without intervention. However, given the potential severity of chest pain in adults, it’s crucial to seek medical evaluation to rule out more serious conditions, such as heart disease.

Prevalence and Demographics

Costochondritis is remarkably common, especially among younger populations. It accounts for 10% to 30% of all chest pain cases in children, with an estimated 650,000 cases annually in individuals aged 10 to 21. The condition peaks in prevalence between ages 12 and 14. In adults, there’s a notable gender disparity, with women being more affected than men (70% vs. 30%).

Costochondritis vs. Tietze Syndrome: Understanding the Distinction

While costochondritis is often confused with Tietze syndrome, these are distinct conditions with some key differences:

• Onset: Tietze syndrome typically appears suddenly, while costochondritis may develop gradually.
• Pain spread: In Tietze syndrome, chest pain often radiates to the arms or shoulders and can persist for several weeks.
• Swelling: Tietze syndrome is characterized by noticeable swelling at the point of pain, which is not typically present in costochondritis.

Exploring the Causes of Costochondritis

The exact etiology of costochondritis remains unclear, but several factors have been identified as potential triggers:

• Repeated minor trauma to the chest wall
• Overuse of arm muscles
• Arthritis conditions (osteoarthritis, rheumatoid arthritis, ankylosing spondylitis)
• Tumors metastasizing to the chest area
• Viral respiratory infections
• Bacterial infections, particularly in intravenous drug users or post-surgery patients
• Rare fungal infections

Costochondritis often manifests following physical exertion, minor chest trauma, or upper respiratory infections. In children and adolescents, carrying heavy backpacks over one shoulder may increase the risk of developing this condition.

Recognizing the Symptoms of Costochondritis

The primary symptom of costochondritis is chest pain, which typically presents with the following characteristics:

• Sharp pain in the front of the chest, usually on the left side
• Pain exacerbation during deep breathing or coughing
• Tenderness when pressure is applied to the rib joints
• Possible radiation of pain to the back or abdomen

If costochondritis occurs due to post-surgical infection, additional symptoms may include redness, swelling, or pus discharge at the surgical site.

When to Seek Medical Attention

While costochondritis is generally benign, certain symptoms warrant immediate medical evaluation:

• Difficulty breathing
• High fever
• Signs of infection at the rib joints
• Persistent or worsening pain despite medication
• Nausea, sweating, or dizziness

Emergency medical care is necessary if chest pain is accompanied by nausea, sweating, or left arm pain, as these may indicate a heart attack.

Diagnosing Costochondritis: A Process of Elimination

There is no specific diagnostic test for costochondritis. Instead, healthcare providers employ a process of elimination to rule out more serious conditions. The diagnostic approach typically includes:

1. Echocardiogram (ECG)
2. Chest X-rays
3. Blood tests for heart damage markers
4. Physical examination to assess tenderness in the rib joints

For patients with a history of sternum surgery or those at risk for heart disease, additional tests may be recommended:

• Gallium scan to detect increased radioactive material uptake
• White blood cell count to check for signs of infection
• Chest X-ray to rule out pneumonia

Treatment Options and Home Remedies for Costochondritis

Costochondritis often resolves on its own without specific treatment. However, several approaches can help manage symptoms and promote recovery:

Medical Interventions

• Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen
• Prescription pain relievers for severe cases
• Local corticosteroid injections in persistent cases

Home Remedies

• Application of local heat or ice to the affected area
• Rest and avoidance of activities that exacerbate symptoms
• Gentle stretching exercises to improve chest flexibility

Preventing Costochondritis: Lifestyle Modifications and Precautions

While not all cases of costochondritis can be prevented, certain measures may reduce the risk of developing this condition:

• Practicing proper posture and ergonomics
• Avoiding repetitive strain on the chest and upper body
• Using both shoulder straps when carrying backpacks
• Maintaining a healthy weight to reduce stress on the chest wall
• Engaging in regular, low-impact exercises to improve chest flexibility

Long-term Outlook and Management of Costochondritis

The prognosis for costochondritis is generally favorable. Most cases resolve within a few weeks to months, even without specific treatment. However, some individuals may experience recurrent episodes or chronic symptoms. In such cases, long-term management strategies may include:

• Regular physical therapy to improve chest wall flexibility and strength
• Mindfulness techniques and stress reduction practices
• Periodic follow-ups with healthcare providers to monitor symptoms and adjust treatment plans

Can costochondritis lead to long-term complications? While costochondritis itself is not typically associated with serious long-term complications, chronic or recurrent cases may impact quality of life. Persistent pain can lead to reduced physical activity, which may in turn affect overall health and well-being. Additionally, the anxiety associated with recurrent chest pain can be distressing for some individuals.

Coping with Chronic Costochondritis

For those dealing with persistent or recurrent costochondritis, developing effective coping strategies is crucial:

• Education: Understanding the benign nature of the condition can help alleviate anxiety.
• Pain management techniques: Learning relaxation methods and pain coping skills can be beneficial.
• Support groups: Connecting with others who have similar experiences can provide emotional support and practical advice.
• Lifestyle modifications: Identifying and avoiding triggers, maintaining good posture, and incorporating gentle exercises can help manage symptoms.

Is there a link between costochondritis and other inflammatory conditions? Some studies suggest a potential association between costochondritis and certain systemic inflammatory conditions, such as fibromyalgia and seronegative spondyloarthropathies. While the exact nature of this relationship is not fully understood, individuals with these conditions may be more susceptible to developing costochondritis.

Emerging Research and Future Directions

As our understanding of costochondritis continues to evolve, researchers are exploring new avenues for diagnosis and treatment:

• Advanced imaging techniques: Ultrasound and MRI studies are being investigated for their potential to provide more accurate diagnosis and assessment of costochondritis.
• Novel therapeutic approaches: Research into targeted anti-inflammatory treatments and regenerative medicine techniques may offer new options for managing chronic cases.
• Genetic factors: Studies are underway to identify potential genetic predispositions to costochondritis, which could lead to more personalized prevention and treatment strategies.

How does costochondritis impact different age groups? The presentation and management of costochondritis can vary across different age demographics:

• Children and adolescents: In this group, costochondritis is often associated with growth spurts and physical activities. Education about proper backpack use and posture is particularly important.
• Adults: Work-related factors, such as repetitive motions or poor ergonomics, may play a more significant role. Stress management and workplace modifications may be key components of treatment.
• Older adults: In this population, costochondritis may be complicated by existing conditions like osteoarthritis. Treatment approaches may need to be tailored to account for other health concerns and medications.

Differential Diagnosis: Conditions That Mimic Costochondritis

Several conditions can present with symptoms similar to costochondritis, highlighting the importance of thorough medical evaluation:

• Chest wall syndrome
• Slipping rib syndrome
• Precordial catch syndrome
• Thoracic outlet syndrome
• Pleurisy
• Pericarditis

Can dietary changes influence costochondritis symptoms? While there’s no specific diet proven to directly impact costochondritis, some individuals report symptom improvement with anti-inflammatory diets. These typically include:

• Omega-3 rich foods (fatty fish, flaxseeds, chia seeds)
• Antioxidant-rich fruits and vegetables
• Whole grains
• Lean proteins
• Limiting processed foods and sugars

It’s important to note that dietary changes should be made in consultation with a healthcare provider or registered dietitian, especially if there are other health conditions to consider.

The Role of Physical Therapy in Costochondritis Management

Physical therapy can play a crucial role in the management of costochondritis, particularly for chronic or recurrent cases. A tailored physical therapy program may include:

• Postural correction exercises
• Gentle stretching and strengthening of chest and upper back muscles
• Manual therapy techniques to improve rib mobility
• Breathing exercises to reduce strain on the costochondral junctions
• Education on proper body mechanics for daily activities

How does costochondritis affect athletic performance? For athletes, costochondritis can be particularly challenging, as it may significantly impact training and competition. Management strategies for athletes with costochondritis often include:

• Temporary modification of training routines to avoid exacerbating symptoms
• Emphasis on proper warm-up and cool-down techniques
• Use of supportive taping or bracing techniques
• Gradual return-to-play protocols under medical supervision

Athletes should work closely with sports medicine professionals to develop a personalized plan that balances symptom management with performance goals.

Psychological Impact of Chronic Chest Pain

The persistent nature of costochondritis can have significant psychological effects, particularly when symptoms are prolonged or recurrent. Common psychological challenges include:

• Anxiety about potential cardiac issues, despite reassurance
• Depression related to chronic pain and activity limitations
• Frustration with the unpredictable nature of symptoms
• Fear of engaging in physical activities

Addressing these psychological aspects is crucial for comprehensive management. Techniques such as cognitive-behavioral therapy, mindfulness practices, and support groups can be beneficial in helping individuals cope with the emotional impact of chronic costochondritis.

Are there any complementary or alternative medicine approaches for costochondritis? While scientific evidence is limited, some individuals report benefits from complementary therapies such as:

• Acupuncture
• Massage therapy
• Herbal supplements with anti-inflammatory properties
• Yoga and tai chi for gentle stretching and stress reduction

It’s important to consult with a healthcare provider before trying any alternative treatments, especially to ensure they don’t interfere with other medical care or medications.

Future Perspectives in Costochondritis Research

As medical understanding of costochondritis continues to evolve, several areas of research show promise for improving diagnosis and treatment:

• Biomarker identification: Research into specific inflammatory markers may lead to more precise diagnostic tools.
• Advanced imaging techniques: Development of specialized imaging protocols could enhance visualization of costochondral inflammation.
• Targeted therapies: Investigation of novel anti-inflammatory agents that specifically target costochondral tissue.
• Predictive models: Creation of algorithms to identify individuals at higher risk for developing chronic costochondritis.

These advancements may pave the way for more personalized and effective management strategies in the future, improving outcomes for individuals affected by this common but often challenging condition.

Costochondritis — Symptoms, Causes, Tests, and Treatment for Costochondritis — from WebMD

Written by WebMD Editorial Contributors

• What Is Costochondritis?
• Costochondritis Causes
• Costochondritis Symptoms
• Costochondritis Risk Factors
• Costochondritis Diagnosis
• Costochondritis Treatment and Home Remedies
• Costochondritis Prevention
• Costochondritis Outlook
• More

Costochondritis is inflammation of the areas where your upper ribs join with the cartilage that holds them to your breastbone. These areas are called costochondral junctions. The condition causes chest pain, but it’s typically harmless and usually goes away without any treatment. But any chest pain in adults should be taken seriously, so you should be examined and tested for heart disease.

A rare condition called Tietze syndrome is often referred to as costochondritis, but the two are distinct conditions. You can tell the difference by the following:

• Tietze syndrome usually comes on all of a sudden, with chest pain spreading to your arms or shoulder and lasting several weeks.

• Tietze syndrome causes swelling at the painful area (where your ribs and breastbone meet).​​​​​​​

Doctors don’t know exactly why costochondritis happens, but they do know that some things can lead to it: 

• Repeated minor trauma to your chest wall
• Overuse of your arms
• Arthritis. Costochondritis can sometimes be a sign of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, or other conditions that affect your cartilage.
• Tumors. These can move from joints and other parts of your body and settle in your chest.
• Respiratory infections caused by viruses 
• Bacterial infections, especially in people who use IV drugs or have had surgery near their upper chest 
• Fungal infections (in rare cases)

Chest pain linked to costochondritis usually comes on after exercise, minor trauma, or an upper respiratory infection.

• Sharp pain in the front of  your chest, near where your breastbone and ribs meet, typically on the left side. It may spread to your back or belly.
• Pain when you take a deep breath or cough. It gets better when you stop moving or your breathing is quieter.
• Tenderness when you press on your rib joints. If you don’t have this tenderness, you probably don’t have costochondritis.
•  If costochondritis happens because of an infection after surgery, you’ll have redness, swelling, or pus discharge at the site of the surgery.

Call your doctor if you have any of the following:

• Trouble breathing
• High fever
• Signs of infection such as redness, pus, and increased swelling at the rib joints
• Continuing or worsening pain despite medication
• Nausea
• Sweating
• Dizziness

Go to a hospital’s emergency room if you have a hard time breathing or any of the following. They’re not usually caused by costochondritis:

• High fever that doesn’t get better with fever reducers such as acetaminophen or ibuprofen
• Signs of infection at the tender spot, such as pus, redness, increased pain, and swelling
• Persistent chest pain of any type when you also have nausea, sweating, or pain in your left arm. These may be signs of a heart attack. If you’re not sure what’s causing your chest pain, go to the emergency room.

Costochondritis is a common cause of chest pain in children and adolescents. It accounts for 10% to 30% of all chest pain in children. Annually, doctors see about 650,000 cases of chest pain in people ages 10 to 21. The peak age for the condition is ages 12-14.

Kids who often carry heavy book bags over one shoulder can be more likely to develop costochondritis.

In adults, costochondritis affects women more than men (70% vs. 30%).  

There is no specific test for diagnosing costochondritis. To rule out a more serious cause of your chest pain related to your heart or lungs, your doctor will probably start with tests like an echocardiogram (ECG), chest X-rays, and blood test for heart damage, among others. 

If those tests come back normal, they’ll likely see if you have tenderness in any of your rib joints, usually over the fourth to sixth ribs.

If you’ve had sternum (breastbone) surgery or are at risk for heart disease, they may recommend getting a test to see if infection is the cause of your chest pain. Doctors will:

• Look for signs of infection such as redness, swelling, pus, and drainage at the site of surgery
• Recommend a more sophisticated imaging study of the chest called a gallium scan, which will show an increase in the radioactive material gallium 
• Check your white blood cell count to see if it is high, a sign of infection
• Recommend a chest X-ray if pneumonia might be a cause of your chest pain

Home Remedies for Costochondritis

These home remedies may provide relief from costochondritis:

• Over-the-counter  pain relievers such as nonsteroidal anti-inflammatory medications (NSAIDs) like ibuprofen or naproxen as needed
• Using local heat or ice to relieve pain
• Avoiding unnecessary exercise or activities that make the symptoms worse; avoiding contact sports until there is improvement in symptoms, and then returning to normal activities only as tolerated
• Doing stretching exercises

Medications for Costochondritis

Your doctor may suggest the following:

• Prescription-strength NSAIDs.
• A local anesthetic and steroid injection in the area that is tender if normal activities become very painful and the pain doesn’t get better with medicine.
• Narcotics like hydrocodone/acetaminophen (Norco, Vicodin) or oxycodone/acetaminophen (Percocet, Roxicet, Tylox) can help with extreme pain, but, as with any narcotics, there’s danger of becoming addicted to them.
• Steroids. Your doctor can give you a corticosteroid shot directly into a painful joint, but that’s considered something of a last resort.
• Tricyclic antidepressants or cyclic antidepressants like amitriptyline can help ease pain, but they also can have side effects, like weight gain and drowsiness. 
• Antiseizure drugs, usually gabapentin (Neurontin), are typically used to treat epilepsy, but they also may help with costochondritis.
• Infectious (bacterial or fungal) costochondritis should be treated with IV antibiotics. Afterward, antibiotics by mouth or by IV should be continued for another 2 to 3 weeks. You should see a doctor during recovery, and then once a year. 

Surgery for Costochondritis

You may need surgery to remove the sore cartilage if other treatments don’t help. Your doctor can refer you to a surgeon.

Because inflammatory costochondritis has no definite cause, there is no good way to prevent it.

Noninfectious costochondritis will go away on its own, with or without anti-inflammatory treatment. Most people will recover fully.

Infectious costochondritis responds well to IV antibiotics and surgery, but recovery may take a long time.

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Abdominal mass: MedlinePlus Medical Encyclopedia

URL of this page: //medlineplus. gov/ency/article/003274.htm

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An abdominal mass is swelling in one part of the belly area (abdomen).

An abdominal mass is often found during a routine physical exam. Most of the time, the mass develops slowly. You may not be able to feel the mass.

Locating the mass helps your health care provider make a diagnosis. For example, the abdomen can be divided into four areas:

• Right-upper quadrant
• Left-upper quadrant
• Right-lower quadrant
• Left-lower quadrant

Other terms used to describe the location of abdominal pain or masses include:

• Epigastric — center of the abdomen just below the rib cage
• Periumbilical — area around the belly button

The location of the mass and its firmness, texture, and other qualities can provide clues to its cause.

Several conditions can cause an abdominal mass:

• Abdominal aortic aneurysm can cause a pulsating mass around the navel.
• Bladder distention (urinary bladder over-filled with fluid) can cause a firm mass in the center of the lower abdomen above the pelvic bones. In extreme cases, it can reach as far up as the navel.
• Cholecystitis can cause a very tender mass that is felt below the liver in the right-upper quadrant (occasionally).
• Colon cancer can cause a mass almost anywhere in the abdomen.
• Crohn disease or bowel obstruction can cause many tender, sausage-shaped masses anywhere in the abdomen.
• Diverticulitis can cause a mass that is usually located in the left-lower quadrant.
• Gallbladder tumor can cause a tender, irregularly shaped mass in the right-upper quadrant.
• Hydronephrosis (fluid-filled kidney) can cause a smooth, spongy-feeling mass in one or both sides or toward the back (flank area).
• Kidney cancer can sometimes cause a smooth, firm, but not tender mass in the abdomen.
• Liver cancer can cause a firm, lumpy mass in the right upper quadrant.
• Liver enlargement (hepatomegaly) can cause a firm, irregular mass below the right rib cage, or on the left side in the stomach area.
• Neuroblastoma, a cancerous tumor often found in the lower abdomen can cause a mass (this cancer mainly occurs in children and infants).
• Ovarian cyst can cause a smooth, rounded, rubbery mass above the pelvis in the lower abdomen.
• Pancreatic abscess can cause a mass in the upper abdomen in the epigastric area.
• Pancreatic pseudocyst can cause a lumpy mass in the upper abdomen in the epigastric area.
• Spleen enlargement (splenomegaly) can sometimes be felt in the left-upper quadrant.
• Stomach cancer can cause a mass in the left-upper abdomen in the stomach area (epigastric) if the cancer is large.
• Uterine leiomyoma (fibroids) can cause a round, lumpy mass above the pelvis in the lower abdomen (sometimes can be felt if the fibroids are large).
• Volvulus can cause a mass anywhere in the abdomen.
• Ureteropelvic junction obstruction can cause a mass in the lower abdomen.

All abdominal masses should be examined as soon as possible by the provider.

Changing your body position may help relieve pain due to an abdominal mass.

Get medical help right away if you have a pulsating lump in your abdomen along with severe abdominal pain. This could be a sign of a ruptured aortic aneurysm, which is an emergency condition.

Contact your provider if you notice any type of abdominal mass.

In nonemergency situations, your provider will perform a physical exam and ask questions about your symptoms and medical history.

In an emergency situation, you will be stabilized first. Then, your provider will examine your abdomen and ask questions about your symptoms and medical history, such as:

• Where is the mass located?
• When did you notice the mass?
• Does it come and go?
• Has the mass changed in size or position? Has it become more or less painful?
• What other symptoms do you have?

A pelvic or rectal exam may be needed in some cases. Tests that may be done to find the cause of an abdominal mass include:

• Abdominal and pelvic CT scan
• Abdominal and pelvic ultrasound
• Angiography
• Barium enema
• Blood tests
• Colonoscopy
• Esophagogastroduodenoscopy (EGD)
• Paracentesis
• Sigmoidoscopy
• Stool analysis
• Urine tests
• X-rays of the chest or abdomen

Mass in the abdomen

• Anatomical landmarks adult – front view
• Digestive system
• Fibroid tumors
• Aortic aneurysm

Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW. Abdomen. In: Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW, eds. Seidel’s Guide to Physical Examination. 10th ed. St Louis, MO: Elsevier; 2023:chap 18.

Landmann A, Bonds M, Postier R. Acute abdomen. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 46.

McQuaid KR. Approach to the patient with gastrointestinal disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 123.

Updated by: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

symptoms, prognosis, causes, diagnosis and treatment of bronchial carcinoma

Contents:

• Causes and risk factors for bronchial cancer
• Signs of bronchial carcinoma
• Bronchial cancer classification
  • Histological
  • ICD-10 code
  • Stages
• Diagnosis of bronchial cancer
• Bronchial oncology treatment
• Bronchial cancer prognosis

Cancer of the bronchi is a malignant tumor that develops on the mucous membrane of the bronchi of large, medium or small caliber. This is a common and dangerous cancer. Together with alveolar cancer, it is in second place in terms of occurrence and in first place in terms of mortality among all malignant neoplasms. Exposure to carcinogens in the air is one of the main causes of bronchial cancer. This effect is gradually increasing, which is why the incidence of bronchial oncology is growing.

It is most often detected after the age of 45, but the disease can also occur in young people. In men, it is detected 6-7 times more often than in women, and this mainly happens after the onset of symptoms, that is, when bronchial cancer has time to develop before the third or fourth stage. Early diagnosis is very important for this disease. Those who smoke, work in hazardous industries or live in areas with polluted air should be regularly examined for prevention.

Causes and risk factors for bronchial cancer

Smoking is the main risk factor for bronchial cancer. All smokers are at risk, but it is especially high for those who:

• smoke more than 1 pack of cigarettes a day;
• has been smoking for over 15 years.

Passive smoking also threatens oncology. If a person is often in a place where people smoke, they can get sick, even if they themselves are not a smoker.

Any other carcinogenic effect on the bronchi can also cause oncology:

• inhalation of coal dust, asbestos, chromium, nickel, mustard gas, other carcinogenic substances while working in hazardous industries;
• long-term residence in areas with heavily polluted air.

Cancer of the central, main bronchus occurs most often because it is best ventilated and when inhaled carcinogens come into contact with the greatest amount of harmful substances.

Hereditary predisposition influences the probability of getting sick. If there were cases of cancer in the family, you need to carefully monitor the state of health, periodically undergo preventive examinations.

Symptoms of bronchial cancer

At an early stage, bronchial cancer may not have symptoms at all. Therefore, the disease is very dangerous. The neoplasm may have time to develop up to the third or fourth stage before noticeable signs appear. It can be detected at an early stage with the help of x-rays. Those who are at risk should take it regularly. Symptoms also depend on which bronchus is affected, and on the characteristics of the tumor itself.

Common signs of bronchial cancer:

• Cough. At first it can be dry, gradually intensifies, sputum appears, in which blood is found over time. Breathing becomes difficult, wheezing.
• Inflammation of the lung. It develops if the tumor completely clogs the bronchus. The unventilated part of the lung becomes inflamed, coughing, shortness of breath increase, and the temperature rises.
• Pain in the side or front of the chest. They appear if the neoplasm grows into the pleura, and pleurisy develops.
• Malaise. Loss of strength, weakness, decreased performance.
• Superior vena cava syndrome. The face becomes puffy, cyanotic, the veins of the neck swell. The condition is urgent, requiring urgent medical attention. It develops at a late stage, if the outflow of blood from the neck and head is disturbed due to the tumor.

Seek medical attention if breathing becomes difficult, coughing or shortness of breath. This is not always associated with oncology – other respiratory diseases can also manifest themselves in this way. In any case, it is necessary to undergo examination and treatment.

Bronchial cancer classification

There are several classification options.

According to histology

The propensity of a tumor to relapse and metastasize depends on its histological structure. There are four types of neoplasms:

• Squamous cell carcinoma of the bronchi – mainly associated with smoking, common, good chances of recovery at an early stage.
• Adenocarcinoma of the bronchi – to a lesser extent due to smoking, can be diagnosed in non-smokers. Carcinoma often affects the bronchi of medium or small caliber. Because of this, its symptoms appear very late.
• Large cell neoplasm may be poorly or highly differentiated. The degree of aggressiveness depends on this (higher for poorly differentiated tumors).
• Small cell bronchial cancer – develops due to smoking. The tumor is very aggressive and difficult to treat.

ICD-10 code

Bronchial cancer code C34 in the ICD-10 classifier. The classifier specifies the localization of the tumor:

• C34.0 – damage to the main bronchi;
• C34.1 – tumor in the upper segment of the lung;
• C34.2 – neoplasm in the middle segment of the lung;
• C34.3 – cancer in the lower segment of the lung;
• C34.8 – defeat outside of any of the above localizations;
• C34.9 Location unspecified.

Stages

In accordance with the TNM system, the stage of cancer is assessed according to three criteria:

• T – the size of the neoplasm in the largest dimension, its localization;
• N – lymph node involvement
• M – metastasis.

There are four stages in the development of a malignant tumor in the bronchi:

• 1 — tumor up to 5 cm, no lymph nodes affected, no metastases;
• 2 – tumor up to 7 cm, possibly affected lymph nodes closest to it, no metastases;
• 3 – neoplasm up to 7 cm or more, may affect neighboring structures, there is damage to the lymph nodes, no metastases;
• 4 – any characteristics of the tumor, any damage to the lymph nodes, there are metastases.

Diagnosis of bronchial carcinoma

Radiodiagnosis is the main way to detect bronchial cancer. Radiography, CT, MRI show changes in tissues, allow you to assess the size and location of the tumor. They are carried out both prophylactically, for those who are at risk, and for suspected oncology. Radiography is performed in two projections. CT and MRI are used to clearly visualize the tumor.

To confirm the diagnosis, bronchoscopy is performed – an examination during which you can examine the epithelium, tumor, and also perform a biopsy, take samples for cytological and histological analysis.

An ultrasound of the chest is performed to assess the extent of the tumor and to check if it has invaded adjacent structures. In the later stages, the oncologist may order additional tests to assess how common the cancerous process is. This may be a bone marrow puncture, a biopsy of the lymph nodes, CT, ultrasound or radiography of individual organs.

Laboratory tests are also performed: clinical, biochemical blood tests, tests for tumor markers, sputum examination.

Methods of treatment of bronchial cancer

An oncologist determines the tactics of treatment, taking into account the stage, aggressiveness, prevalence of the oncological process and other parameters. The main methods are surgery, chemotherapy, radiation therapy.

The operation is carried out in such a way as to completely remove the malignant neoplasm, but at the same time preserve healthy tissue as much as possible. The size and location of the tumor affect how the operation will be performed. If possible, only the tumor itself is removed with a small amount of healthy tissue around it. Removal of only a segment or lobe or the entire lung may also be performed. If the lymph nodes are affected, they are also removed.

Surgical treatment is used in the initial and middle stages of the disease.

During radiation therapy, the neoplasm is exposed to aggressive radiation, reducing it. Such treatment may be given before surgery to make the tumor operable, or after it to reduce the risk of recurrence or metastasis. In advanced stages, radiation therapy is used as the main treatment instead of surgery.

Chemotherapy is treatment with drugs that destroy actively developing tumor cells. Chemotherapy may be given before or after surgery. For inoperable cancer, surgery is not performed and instead, chemotherapy is used along with radiation therapy.

Bronchial cancer prognosis

Survival is affected by the stage and type of bronchial cancer. If the tumor is non-small cell, the prognosis for a patient with bronchial cancer is better. According to various estimates, the chances of a cure are 68–92% for the first stage, 53–60% for the second stage, and up to 26% for the third stage. Small cell cancer is more aggressive, which reduces the chances of recovery. For the first stage they are 31%, for the second 19%, for the third only 8%. For any type of tumor in the fourth stage, the prognosis is unfavorable.

For bronchial oncology, it is very important at what stage the treatment is started. The earlier cancer is detected, the sooner the patient begins to receive medical care, the greater the chance of a successful outcome. Therefore, for those who smoke, work in hazardous industries, or are at risk for other reasons, it is important to regularly undergo preventive examinations.

Sources:

1. Aidinov G.T. Multivariate analysis of the structure and contribution of potential risk factors in malignant neoplasms of the trachea, bronchi and lung / G.T. Aidinov [et al.] // Analysis of health risks. – 2017.
2. Kontsevaya A.Yu. Endoscopic semiotics of metastatic bronchial tumors / A.Yu. Terminal [and others] // Modern Oncology. – 2021. – No. 23 (1). – S. 100-104.
3. Laktionov K.K. Malignant neoplasm of the bronchi and lung. Clinical guidelines / K.K. Laktionov [et al.] // Modern Oncology. – 2022. – No. 24 (3). – S. 269-304.
4. Pronevich A.V. Aggressive course of bronchial cancer / A.V. Pronevich, P.N. Kovalchuk // Problems of health and ecology. – 2020. – No. 3 (65). – p. 119-122.

Information verified by an expert

Mikhailov Alexey Gennadievich
operating oncologist, doctor of the highest qualification category, Ph.D.
experience: 22 years

The information in the article is provided for reference purposes and does not replace the advice of a qualified specialist. Do not self-medicate! At the first sign of the disease, you should consult a doctor.

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Under the general name “Tumors of the chest” refers to both benign and malignant neoplasms that can grow from soft tissues or bone structures. At the same time, tumors of the skin and pleura are not included in this section – they are considered as neoplasms of the skin and lungs, respectively.

Various neoplasms of the anterior chest wall can initially form from its constituent tissues, and are also brought there by metastasis of malignant tumors of other organs. For example, their appearance may be the result of breast cancer not detected at an early stage.

Types of tumors of the chest wall

Specialists in the field of thoracic surgery use the following classification of such neoplasms:

• benign – lipomas, hemangiomas, osteomas and other non-life-threatening and non-metastasizing tumors;
• malignant. First of all, these are various types of sarcoma, as well as germination of the chest with cancerous tumors of the lungs and a product of abundant metastasis of malignant tumors of other organs.

How do such neoplasms manifest themselves?

Benign soft tissue tumors of the breast develop gradually. They do not cause pain to the patient and, in general, represent an aesthetic defect rather than a serious disease.

Benign neoplasms of the bone structures of the chest wall develop from bones and cartilage. Those of them that are located on the side of the back usually grow from the body of the scapula and move along with it during movements. They increase in size very slowly, and their rapid growth is usually one of the symptoms of their malignant transformation. They don’t itch or hurt. They can reach significant sizes, while not having a serious impact on the general condition of the patient. The only exception to the general rule is the germination of the chondroma inside the chest, causing discomfort and pain in the chest, a feeling of lack of air, and shortness of breath.

As for cancerous tumors of the chest wall, they are characterized by a rapid increase in size. As they progress, they may ulcerate and disintegrate in the middle. As the size of the malignant tumor increases, the patient’s condition becomes more severe. He can suffer from a constant fever, symptoms of severe intoxication of the body, cough, hemoptysis, and also lose a lot of weight in a matter of weeks. Germination or mechanical pressure of the tumor on the nerves is accompanied by severe pain.

Diagnosis and treatment of chest wall tumors

Most often, in the early stages, neither benign nor malignant neoplasms manifest themselves at all. Often, they are discovered incidentally during an imaging chest examination, such as in preparation for a pleural puncture.

Treatment of neoplasms of the chest is carried out exclusively by surgery. If we are talking about cancerous tumors, then the effectiveness of such treatment can be greatly increased by chemotherapy or radiation therapy. It can be carried out in courses both before and after the operation. Today, cancer is not a sentence: the achievements of modern medicine allow patients who have been given a disappointing diagnosis to live a full life until old age!

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Prices

Name	Cost
Primary surgical debridement (PSW) 1 category of complexity (uncomplicated, without suturing)	RUB 1,700
Primary debridement (PSW) 2nd category of complexity (complicated, with suturing)	RUB 2,500
Primary surgical debridement (PSW) 3rd category of complexity (complicated, with suturing)	RUB 3,500
Treatment of a wound after thermal damage to the skin of the 1st degree	RUB 1200
Wound treatment after thermal damage to the skin 2nd degree	RUB 2,000
Aseptic dressing application	800 rub.
Medication dressing	800 rub.
Surgical suture (one suture)	300 rubles
Clean dressing (including postoperative)	550 r.
Complicated wound dressing	1000 rubles
Dressing of small festering wounds	RUB 1200
Dressing of large festering wounds	RUB 1,600
Treatment of superficial skin lesions	800 rub.
Antiseptic wound dressing with antiseptic dressing	1000 rubles
Dressing with application of ointment forms	800 rub.
Cosmetic sutures (per centimeter)	850 rubles
Facial sutures, single suture	300 rubles
Body sutures, one suture	250 rubles
Removal of plaster sutures	300 rubles
Removal of postoperative sutures	550 r.
Aspiration biopsy (examination cost not included)	550 r.
Collection of material for histological examination (examination cost not included)	550 r.
Fine-needle puncture biopsy of the breast mass (without the cost of histological examination)	RUB 1200
Papilloma removal (1 element)	500 rub.
Removal of a cyst, hemangioma, lipoma, atheroma 1 category of complexity	RUB 3,500
Removal of a cyst, hemangioma, lipoma, atheroma, including festering 2 category of complexity	RUB 5,000
Removal of a cyst, hemangioma, lipoma, atheroma, including festering 3 category of complexity	7 500 rub.
Removal of benign skin lesions up to 0.5 cm	RUB 2,000
Removal of benign skin lesions from 0.5 to 1.5 cm	RUB 3,000
Removal of benign skin lesions over 1.5 cm	4000 rubles
Resection of ingrown nail 1 category of complexity	3 500 rub.
Resection of the ingrown nail, 2nd category of complexity with plastic surgery of the nail bed	RUB 5,500
Surgical removal of the nail plate of 1 finger	RUB 2,500
Excision of scar tissue (per 1 cm)	1500 rub.
Foreign body removal with soft tissue incision	RUB 3,500
Opening and drainage of festering hematoma	4 500 rub.
Hematoma opening and drainage	RUB 3,000
Hematoma evacuation (small, subungual)	1500 rub.
Wound probing	550 r.
Drain Replacement	500 rub.
Opening and drainage of abscess	3500 r.
Major purulent surgery (carbuncles, phlegmon, abscesses)	RUB 6,000
Minor purulent surgery (boils, felons, paronychias)	RUB 3,000
Fistula excision 1 category of complexity	RUB 5,000
Fistula excision 2 category of complexity	RUB 7,000
Tick removal, wound care	RUB 1200
Lymph node puncture (examination cost not included)	800 rub.
Puncture of soft tissues and superficial formations (examination cost not included)	800 rub.
Puncture of the pleural cavity (examination cost not included)	1700 rub.
Collection of smear-imprint of the separated breast (examination cost not included)	250 rubles
Medical treatment of venous trophic ulcers	750 r.
Compression phlebosclerotherapy procedure (2 ml)	3 300 rub.
Microsclerotherapy treatment for spider veins (2 ml)	RUB 3,300
Postoperative dressing	550 r.
Ultrasound-guided tumescent anesthesia (1 leg)	RUB 1,700
Sclerosis of the veins of the lower extremities (1 ampoule)	5800 r.
Vein sclerosis of one hand	6100 rub.
Vein sclerosis of one foot	6100 rub.
Sclerosis of the spider veins of the lower extremities (1 ampoule)	5200 rub.
Ultrasound-guided non-surgical sclerobliteration of the great saphenous vein	RUB 10,500
EVLO operation standard	32000 rub. Leave a Reply Cancel reply Your email address will not be published. Required fields are marked * Comment * Name * Email * Website