Understanding Nodules, Polyps, Cysts, and Hyperplasia: What to Do?

Most people feel a jolt when they see the word “nodule” on their health check report. What exactly is a “nodule”? Is surgery necessary?

It must be said that in 2020, people became more concerned about health check-ups. At the same time, results like “nodule”, “hyperplasia”, “polyp”, and “cyst” frequently appeared on health reports. When confronted with such “abnormalities”, many feel uneasy, worried that minor health issues might develop into serious illnesses. Today, let’s clarify the origins and implications of nodules, hyperplasia, polyps, and cysts!

Almost everyone has some nodules. Statistics show that there are over 100 million patients with lung nodules in the country.

However, nodules in the body tend to “hide” in various places, and because they are small and not easily felt or seen, they can be concealed in the lungs, breasts, thyroid, prostate, etc. Only during health checks do they gradually come to light.

Nature: Over 90% are benign, but caution is still necessary.

Examination Methods: If smaller than 1cm, a CT and MRI are required; if larger than 1cm, a chest X-ray should be done. Larger nodules should ideally be re-examined every 2-3 months.

At-risk Groups: Long-term smokers, those working in cooking, or frequently exposed to heavily polluted gases or substances.

Nature: Over 90% are benign, with low chances of malignant transformation.

Examination Methods: It is recommended to visit a hospital for ultrasound, mammography, and MRI to determine if it is benign or malignant.

At-risk Groups: Those who frequently wear tight bras, those who often feel stressed, or those with endocrine disorders.

Nature: Over 95% are benign.

Examination Methods: Ultrasound, CT, and contrast examinations are needed, with a follow-up once a year; generally, treatment is not required unless it compresses the trachea or surrounding tissues.

At-risk Groups: Women, those on low-iodine diets, and individuals with a family history.

For some obvious nodules, we can self-assess whether they are benign or malignant.

Benign nodules feel similar to the tip of the nose or lips, have clear edges, and are movable; malignant ones feel firmer, similar to the forehead, have unclear boundaries and irregular shapes, and are more fixed in position.

Thus, benign nodules should be followed up every 2-3 months; if there are no significant changes, once a year is sufficient; if they cause pain, surgical removal should be considered. Malignant nodules should be removed as soon as possible.

Hyperplasia can be physiological or pathological; it is a phenomenon where the number of cells in a tissue or organ increases due to active mitosis.

In fact, physiological hyperplasia typically does not require treatment, while pathological hyperplasia can significantly impact the body but does not necessarily lead to cancer.

Many people find “bone spurs” developing at their joints, causing frequent pain, which is quite bothersome. In fact, these “bone spurs” may not be harmful and can even be beneficial.

“Bone spurs”, or bone hyperplasia, are a natural sign of aging, especially common in middle-aged and elderly individuals over 45. Poor posture, sports injuries, and other factors can affect joints, ligaments, and muscles, leading to instability and degenerative diseases.

The appearance of bone hyperplasia is a self-protective response of the joints to maintain stability. If severe joint swelling and pain occur, one should be wary of hyperplasia and seek medical treatment promptly.

It is reported that 80% of women will experience breast hyperplasia. Generally, breast hyperplasia is mostly physiological, primarily caused by hormonal imbalances, and does not require extensive treatment. It is advisable to adjust lifestyle, dietary habits, and emotions, and medication can be combined when necessary.

However, there is a 2%-3% chance of malignant transformation in breast hyperplasia, with cystic breast hyperplasia having a cancer rate 3-5 times higher. Therefore, persistent breast pain and lumps may require further examination to prevent malignancy.

This type of hyperplasia is undoubtedly a concern for men. Prostate hyperplasia is a physiological change characterized by frequent urination, urgency, difficulty urinating, increased nighttime urination, and even urinary incontinence, which can initially be treated conservatively.

From the nasal cavity, gastrointestinal tract, to the uterus, mucous membranes can mysteriously cover one or more “meat-like” growths, which are polyps.

Polyps grow slowly and are often only the size of a green bean at first, making them difficult to detect. The most common type, colorectal polyps, is among the more dangerous family of polyps, as they can undergo malignant transformation and ultimately lead to colon cancer. If found during examination, they should be removed promptly, and regular colonoscopy checks should be done to prevent recurrence.

There are also hereditary polyps, such as familial adenomatous polyposis, which are even more concerning as they have a higher likelihood of cancer transformation.

Additionally, gallbladder polyps may cause abdominal pain and are considered benign tumors. If the polyp is less than 1cm, surgery is not necessary; a B-scan check is sufficient every 1-2 years; if it exceeds 1cm, immediate removal is necessary to prevent cancer transformation.

It is recommended that low to medium risk polyps be rechecked within 1-3 years after removal, while more severe cases should be rechecked every 3-6 months.

Upon hearing the term “cyst”, some mistakenly believe it is synonymous with tumors. In fact, cysts and tumors, although only a word apart, are fundamentally different!

A cyst is a benign lesion caused by genetics, infections, trauma, parasites, etc. Most cysts are harmless and do not require treatment; regular observation or follow-up is sufficient.

Cervical cysts: When small and asymptomatic, just maintain hygiene; if they grow larger and cause bleeding during intercourse, then anti-infection treatment or surgical removal is necessary.

Ovarian cysts: These include corpus luteum cysts and follicular cysts. The former usually resolves naturally after four months of pregnancy; the latter, if smaller than 5cm, requires only observation.

In summary, if a cyst affects normal organ function, surgical removal should be considered, or methods such as sclerotherapy with alcohol or aspiration to drain the cyst fluid should be employed.