Encrypted by numerous code combinations in ICD-10, lung neoplasms are a serious oncological problem that has become more and more common lately. With timely identification of the case and the start of adequate therapy, the patient can count on good prognosis, but with certain forms, a high degree of malignancy of formation and at an advanced stage, there is a risk of incurability of the condition.
About ciphers and codes
For neoplasms in the lungs, ICD-10 introduced several numeric and letter combinations at once. For example, D38 is a cipher under which pathological malignant processes are hidden, whose nature cannot be clarified, determined.
In the general case, when detecting malignant processes in the bronchi, neoplasms in the lungs, the ICD code is C34. But if the neoplasm is benign, it is coded with the symbols D14. If the malignancy is secondary, the caseencrypted as C78.0. They also use the code in the ICD D02.2 for a neoplasm in the lung. It is used if carcinoma is detected in the lungs, bronchi.
A specific code (or several) must be recorded in the client's card. The attending physician of the patient is responsible for the correct choice of the cipher and its fixation in the documentation.
General information
A malignant neoplasm in the bronchi and lungs is a pathological condition caused by abnormal cell development in the epithelial tissues of the respiratory system. Among other malignant pathologies that provoke a lethal outcome, lung cancer occupies a confident first place. This is confirmed by world medical statics. The disease threatens people of different sex and age, with a high degree of probability it can cause death in patients of all groups. To some extent, this is due to blurred symptoms, which for a long time do not allow the patient to suspect the presence of malignant areas.
A neoplasm in the right lung, the left one can develop in a peripheral or central form. There are massive cases of mixed scenario development. There is a risk of malignancy of various parts of the respiratory system. Up to 95% of cases are due to the degeneration of epithelial cells, which play the role of lining the air passageways of medium, large size. Consequently, bronchioles and bronchi are most often the first to suffer. In a number of sources, the term "bronchogenic carcinoma" is used for the pathological condition.
It is known that the neoplasm in the left lung, the right candevelop on the basis of pleural cells. This case is called mesothelioma. It is extremely rare that the process starts from auxiliary lung tissues, including the circulatory system.
Where did the trouble come from?
The causes of neoplasms in the bronchi and lungs have been of interest to scientists and physicians for more than a decade. The link with smoking is well established, and it is the use of tobacco products that is considered the main cause of the process. About 80% of patients are heavy smokers. In the remaining 20%, external factors probably play a role: being in rooms contaminated with radon, the need to work with asbestos dust. Some heavy metals are carcinogenic. Higher risk of getting sick if you have to come into contact with chloromethyl ether.
It has been established that neoplasms of the lungs (the ICD considers this pathology in several categories) can form against the background of chronic foci of inflammation in the respiratory system. Certain risks are associated with pulmonary fibrosis.
Explaining why smoking affects human he alth so much, scientists studied the properties of tobacco products. The smoke emitted during the combustion of a cigarette is rich in chemical components that play the role of carcinogens. In addition, a set of physical factors provokes the start of malignant processes, including a sharp temperature drop when inhaling hot smoke.
How to suspect?
If a person coughs for a long time, and blood inclusions appear in the sputum, one should think about the causes of the phenomenon. Indeed, what could it be? A neoplasm in the lungs is one of the factors that can provoke such symptoms. In general, it is not easy to describe the exact clinical picture, especially for the first two stages of the development of the disease. Manifestations are quite diverse, depending on the localization of the degenerated zone and the magnitude of the pathological formation. In an impressive percentage of cases in the first stages of cancer, there are no specific symptoms at all, almost always early diagnosis of the disease is a serious challenge.
Fixed with codes D02.2, D38, C34, C78.0 ICD neoplasms in the lungs often indicate themselves with a persistent cough, respiratory failure, and soreness in the chest. Gradually, spitting up blood becomes more and more frequent and pronounced, the patient loses weight for no apparent reason. Any indicated symptom should be a reason to consult a doctor, even if the others do not accompany it. It is known that an impressive percentage of deaths from lung cancer is due to too late access to a specialist. The signs are non-specific and appear in various pathologies of the respiratory system, which makes it difficult to clarify the case. Cancer can be suspected if, in addition to at least one of these symptoms, apathy, loss of activity, lethargy, and temperature rise from time to time. There are cases when cancer was mistaken for pulmonary inflammation, bronchitis.
Attention to laboratory indicators
If, for various reasons, a person is tested, some resultsoblige to consider the possibility of the presence of a malignant, benign neoplasm in the lungs and to carry out diagnostic measures to confirm or refute the hypothesis. In particular, an increased content of calcium in the circulatory system may indicate a squamous type of disease, and an unreasonable increase in the percentage of sodium - small cell. The oat cell form can be suspected if laboratory tests confirm hypertrophic osteoarthropathy. The phenomenon was called paraneoplastic syndrome. A successful therapeutic course directed against the underlying pathology makes it possible to achieve its disappearance.
Diagnosis nuances
In about 15% of cases, a malignant neoplasm in the lung at the initial stage does not provoke any symptoms at all, even non-specific ones. The only way to detect pathology at this step is an instrumental examination. In practice, most often, fluorography helps to make a diagnosis on time, which the citizens of our country must undergo annually. The survey is free, takes only a few minutes, so it is available to everyone. If the result is an image with a darkened area, the patient is referred for additional studies until the nature of the spot can be identified and the presence of a malignant process can be confirmed or denied.
If a malignant neoplasm in the lung has caused metastases, the symptomatology of this step of the process can be severe pain. The syndrome is especially pronounced if atypical cellscovered the skeletal system. With brain damage, there is a possibility of visual impairment, convulsions. Patients experience headaches and dizziness, the condition resembles a stroke, certain parts of the body lose sensitivity, muscle tissue weakens.
Symptoms: Summing up
It is necessary to suspect a neoplasm in the lungs and consult a doctor for diagnosis if you are worried about a constant cough, while the discharge contains blood inclusions. If the cough is chronic, not associated with malignant processes, a complication, an aggravation of this phenomenon, may indicate a pathology. There is a possibility of cancer if the infection of the respiratory organs is prone to recurrence, the person often suffers from bronchitis or suffers from discomfort, soreness in the chest. Sudden weight loss, increased fatigue, breathing problems, wheezing are reasons to make an appointment with the doctor, as these symptoms can also indicate cancer.
Check everything
Assuming cancer, the doctor refers the patient to instrumental studies. One of the first to carry out CT, MRI. Using such methods, it is possible to identify the dimensions, prevalence, accurately localize the diseased area. The difference between these two methods and an x-ray is in high sensitivity, the ability to detect cancer at an early stage, even if there are no symptoms of the disease. But x-rays usually show a fairly large neoplasm. Such a picture allows you to quickly identify metastases.
If it is necessary to clarify the condition of the patient,bronchoscopy is ordered. The study is carried out using an endoscope, in real time receiving an image of the internal lung structures through a fiber-optic tube. The doctor can examine the patient's respiratory system from the inside, see with his own eyes the location of the neoplasm and the level of its growth, and also obtain cell samples for histological analysis.
Types and stages
Identify peripheral neoplasms in the lung, central. The area can be flat-, large-, small-celled. There are mixed forms and adenocarcinoma. To clarify the stage, it is necessary to identify the exact dimensions of the formation, assess the degree of penetration into nearby structures, tissues, check the lymphatic system and other organs for metastases. Determination of the exact stage is necessary for the selection of an adequate therapeutic program. For each step in the development of the disease, unique treatment strategies have been developed. Clarification of the stage allows you to correctly predict the future of a person. The deeper and more neglected the process, the less likely it is to be completely cured.
The first stage is called such a neoplasm in the lungs, the dimensions of which are up to 3 cm, the process does not affect the pleural tissues, regional lymph nodes, metastases cannot be detected. With the same dimensions, but the presence of metastases in the lymphatic system of the bronchi, the second stage of the disease is diagnosed.
Continuing the theme
The third stage is usually divided into A and B. The first is a neoplasm in the lungs, in which the degeneration of cells affected the visceral pleural tissues, chest wallcells, pleural mediastinal cells. The dimensions of the neoplasm do not play a role. Invasion can be observed against the background of metastases in the lymph nodes of the mediastinum, bronchi on the opposite side from the original focus. The third stage, subtype A, is diagnosed if only described metastases are observed without tissue infiltration.
Type B of the third stage is also diagnosed regardless of the size of the neoplasm of the lungs. Important factors will be infiltration into the mediastinum - esophageal, vascular, cardiac, vertebral tissues. Perhaps the appearance of metastases in the lymphatic system of the bronchi, lungs on the opposite side from the original focus. Metastases can be found in the lymphatic system of the supraclavicular region, mediastinum.
When distant metastases are detected, the fourth stage is diagnosed. The same diagnosis is made if the malignant processes are small cell carcinoma of a limited, widespread type.
About the categories in more detail
Central malignant formation is localized in bronchial segments, large bronchi. Here, squamous, non-small cell forms of oncological diseases are detected. The peripheral type, as the name implies, is localized on the pulmonary periphery. With it, alveoli, small bronchial structures, branches of the bronchi are reborn. The main danger of this form is the flow with virtually no symptoms for a long time. As a rule, the first signs of the disease appear only at the fourth stage, when the tumor is already becoming large and compresses the nearbystructures, there was infiltration into large bronchi, pleural tissues, chest.
Rarely, pleural mesothelioma is detected. This is a rather aggressive form of the disease, originating from the pleural membranes.
Forms, stages and strategies
Based on the degree of the process, it is possible to assess the type of neoplasm, the features of its development, distribution, dimensions, and the specifics of infiltration. This information is needed to make an adequate forecast. The stage, other features of the case influence the choice of a therapeutic approach. A better future awaits patients who come to the clinic with stage zero. Treatment will bring good results even at the first stage of pathology development. On the second, third, the prognosis is much worse, but there are certain chances for a full recovery. At the fourth stage, it is almost impossible to achieve a cure and even a long-term stabilization of the condition.
When a neoplasm is detected, special attention should be paid to metastases. If they already exist, the therapeutic course in the predominant percentage of cases is palliative. If none are found, surgery is indicated. A neoplasm in the lungs with a high degree of probability, following a radical intervention, will be eliminated without consequences and relapses in the future.
Future: what to expect?
The prognosis is determined by the nuances of localization, the size of the neoplasm, the severity of symptoms, the type of atypical cells, and the state of human he alth in general. For lung canceron average, the prognosis is worse than for most other malignant diseases. The survival rate is relatively low relative to a number of other forms of disease. So, in the analysis of five years, the average survival rate is only 16%. For comparison, with a malignant neoplasm in the large intestine for the same time period, survival is estimated at 65%, and with malignancy of breast cells - 89%.
The worst prognosis in case the neoplasm develops according to the scenario of small cell degeneration. Chemotherapy alone and in combination with other therapeutic approaches can prolong the life of the patient by an average of five times. However, the five-year survival rate for small cell malignancies has been estimated at an average of 5-10%. The main percentage of survivors are people suffering from a limited form of the disease.
Can I warn you?
The main preventive measure is the complete exclusion from your life of smoking, not only active, but also passive. To give up a bad habit, you can resort to the help of doctors - narcologists, psychologists. Many products have been developed that simplify the withdrawal period (inhalers, chewing gum, tablets). The first ten years after quitting tobacco products are associated with an increased risk of malignant processes, but the likelihood of their development gradually decreases.
To eliminate radon from the premises, it is necessary to constantly ventilate all habitat areas and do wet cleaning. If the building frame is made of reinforced concrete, surfaces in living and working premises should be treated, paintedor wallpaper. If possible, contact with heavy metals, asbestos dust should be avoided. This is especially important for people working in industrial areas.
Eating right is important. Scientists are convinced that it is possible to reduce the risk of neoplasm if you dilute the diet with natural antioxidants. Fruits, greens, vegetables contain ascorbic acid, retinol, tocopherol, which reduce the risk of malignant processes in the respiratory system.
Latest technology: CyberKnife
Some modern clinics offer the treatment of cancer processes through the CyberKnife method. Movement accuracy is estimated at 0.5 mm. The technology belongs to the category of radiosurgery and is carried out without direct contact. By means of a special installation, a malignant neoplasm is treated with thin beam beams. In just three sessions, it is possible to completely destroy the pathological zone without harming nearby organic structures, including the aorta. Such an operation does not require hospitalization, there is no need to cut anything. Not even general anesthesia is required.
CyberKnife is considered to be highly accurate, and its use is associated with a minimum level of danger. Special marks are placed in the tumor borders, harmless to humans, but simplifying the targeting of ionizing beams. Before applying the next beam, the computer evaluates the localization of the tumor, its displacement, due to which the energy supply is ensured as accurately as possible.
If the patient has made a decision in favor of technology"CyberKnife", for the period of intervention, he will be put on a vest that provides protection and simplifies control over breathing, involuntary displacements of the body. Consequently, all the rays will hit exactly those points that need to be processed according to the plan. Similarly, metastases localized in the lungs can be destroyed.
