A 63-year-old woman had severe coughing at night. The puncture under CT guidance revealed the true shape of the nodule.

Aunt Mo, 63 years old this year, started coughing and sputum after catching a cold half a year ago. She coughed up a small amount of white mucus sputum, but did not take it seriously. She only received intravenous treatment locally, but her symptoms did not improve significantly. She coughed violently at night and had difficulty falling asleep. More than 10 days ago, her cough worsened, her appetite decreased, and she lost 10 kilograms in weight, so she went to the respiratory department for treatment.

After the consultation, the attending physician, Dr. Zhou, immediately completed the relevant examinations: three routine tests (blood, urine, and stool), liver and kidney function electrolytes, tumor markers, fasting blood sugar, and chest CT examination.

However, a chest CT scan revealed a nodule in the right lung, measuring approximately 2.0×2.6 cm. Further chest CT enhancement scan was performed, which was considered to be a malignant tumor.

When Aunt Mo heard that something had grown in her lungs, her body began to tremble and she was terrified.

Dr. Zhou told Aunt Mo not to worry, there would always be a way.

After multidisciplinary discussions, the hospital decided to develop a diagnosis and treatment plan: first, puncture the nodule under CT guidance to obtain some tissue for pathology, and then proceed to the next step of treatment after the pathology results are clear.

After Aunt Mo and her family learned about the hospital's plan, they felt that the trauma would be minor and agreed to cooperate with the treatment.

Doctor Nie Qing is the chief technician of the imaging department. Considering that Aunt Mo is old and very nervous, he came to comfort her and explained the general process of CT puncture and precautions for cooperation.

On the day of the examination, Dr. Zhou placed a fence on the skin, and Dr. Nie Qing operated the CT machine to scan it. Scanning layer by layer and adjusting angle by angle slowly ensured the accuracy of the puncture.

After determining the angle and depth of needle insertion, Dr. Zhou disinfected the puncture site, laid a sterile sheet, and injected 10 ml of local anesthetic lidocaine.

Afterwards, three pieces of tumor tissue were removed by biopsy gun using a special puncture positioning needle. Before and after the needle was removed, Dr. Nie Qing scanned the puncture site again to ensure that there was no obvious bleeding or pneumothorax.

Overall, the whole process went smoothly. Aunt Mo felt no pain and no obvious discomfort.

After Aunt Mo was put down on the scanning bed, she said, "Is it okay now? It's not as scary as I imagined. I can walk back by myself."

Two days later, the pathology results came out, it was lung cancer.

Afterwards, Dr. Zhou began to provide Aunt Mo with systematic and standardized treatment based on the lung cancer diagnosis and treatment guidelines.

In this case, since the patient is an adult, local anesthesia is generally sufficient. If you encounter an uncooperative patient or child, the anesthesiology department will need to perform sedation or intravenous anesthesia to perform the puncture.

Many people are afraid of nodules, but not all nodules are bad. Below, we will learn about this:

Pulmonary nodules refer to single or multiple pulmonary nodules with clear boundaries, opaque imaging, a diameter of ≤3 cm, and completely surrounded by air-containing lung tissue. They are characterized by atelectasis, hilar enlargement, and pleural effusion. The size and characteristic information of nodules are of great significance for the judgment of benign or malignant and the formulation of subsequent treatment plans.

After the chest CT scan finds lung nodules, the clinician will conduct scientific and systematic auxiliary examinations. After comprehensive evaluation, the next step will be formulated. For difficult cases, the MDT (multidisciplinary consultation team) will be organized to analyze and discuss, comprehensively evaluate and formulate treatment plans, and conduct nutrition and mental health education.

The number of elderly people over 60 years old is gradually increasing, and the disease is becoming younger, so we must emphasize "early detection, early diagnosis, and early treatment." At the same time, we must continuously improve our awareness of self-health care and health examinations.

Some people would say that there will always be problems during physical examinations, and problems will affect your mood, so it is better not to have a physical examination.

In fact, there is no need to worry too much about many diseases. Science is advancing and doctors will give reasonable treatment plans based on the situation.

Regular health check-ups are very necessary. Through physical examinations, you can know your physical condition and detect physical abnormalities at an early stage. If you need treatment, you can cooperate with the doctor to actively treat it. If you don't need treatment, you can just pay attention to your life. In addition, we should promote a healthy lifestyle, cultivate a positive and healthy mentality, and improve the quality of life.

Finally, we would like to emphasize again that lung cancer is all about prevention, and early diagnosis and treatment are the key!

Author: Nie Qing, Chief Technician, Department of Imaging, Funan County People's Hospital

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