BRONCHIAL STENOSIS DUE TO CENTRAL LUNG CANCER
Authors: A.V. Aliyev
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The lung cancer on number of again falling ill persons keeps first place in the world among men and the fourth place among women. (16, 24, 26, 27, 32) All forms of the central lung cancer, but much earlier endobronchial eventually leads to a bronchial stenosis. (29, 32) Diagnostic process of stenoses of large bronchi includes studying a roentgen-computer picture of bronchi, carrying out on this basis bronchoscopy with a capture of a pathological material for citomorphological investigation. (5, 18, 27, 31) It is a unique method of specification of the true reason of organic bronchial stenoses.
Central lung cancer is the tumour affecting proximal, i.e. the central departments of a bronchial tree, including subsegmentary branches also. (3, 31, 32) In conformity with development of bronchoscopic technique last decades became accessible to survey not only segmentary bronchial tubes, but also their subsegmentary branches, i.e. bronchial tubes of the fourth order. Accordingly, distal border of the central cancer was displaced: it is a tumour affecting main, intermediate, the share, segmentary and subsegmentary bronchi. (3, 31) The tumour which source is little bronchus, at presence expressed peribronchial node, is considered as a peripheral cancer. (3, 31) In part, the tumour growing outside from a bronchial tube, refers to - peribronchial, growing inside - endobronchial. Hence at the central cancer the bronchial stenosis is caused endoluminal by the located tumoral growths at endobronchial to the form, or peribronchial squeezing at peribronchial to the form of growth of a tumour. (19, 23, 31) It is necessary to note that, central peribronchial cancer in difference from endobronchial is characterized by indirect attributes, which else up to biopsy allow well founded to suspect the tumoral nature of bronchial stenosis. (15, 32) But, the peribronchial stenosis is better displayed at CT. (11, 26, 29) In part, each of these forms can be shown as nodal or infiltrative growth. In case of endobronchial cancer nodal growth inside of a lumen of a bronchial tube refers to extraluminal, and mucous membrane infiltration and undermucous layer - intraluminal. As the extra form consider extreme expression infiltrative growth with endobronchial defeat of bronchial tree on the big extent. It’s frequent with transition to a trachea and the opposite side. Such kind of a tumour has received the name branched out. (3, 31) Many authors allocate also the mixed type of growth of a tumour. (27) In all cases of the mixed growth the tumour quickly is exposed sclerosing, involving in process not only share but also segmentary bronchi, (11, 27, 31) And at bronchoscopy are diagnosed symptoms infiltration of mucous membrane, on roentgenograms of thorax and CT comes to light peribronchial shadow of tumour. (18, 29)