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Adenocarcinoma - chest X-ray
Adenocarcinoma - chest X-ray


Pulmonary nodule - front view chest X-ray
Pulmonary nodule - front view chest X-ray


Pulmonary nodule, solitary - CT scan
Pulmonary nodule, solitary - CT scan


Respiratory system
Respiratory system


Definition:

A solitary pulmonary nodule is a round or oval spot (lesion) in the lungs that is seen with a chest x-ray or CT scan .



Causes, incidence, and risk factors:

More than half of all solitary pulmonary are noncancerous (benign). Benign nodules have many causes, including old scars and infections.

Infectious granulomas are the cause of most benign lesions.

You have a greater risk for developing a solitary pulmonary nodule if you have:

However, the above conditions makes it more likely that the solitary pulmonary nodule is noncancerous.

Young age, history of not smoking, calcium in the lesion, and small lesion size are factors associated with a noncancerous diagnosis.

Lung cancer is the most common cause of cancerous (malignant) pulmonary nodules.



Symptoms:

There are usually no symptoms.



Signs and tests:

A solitary pulmonary nodule is usually found on a chest x-ray. If x-rays repeated over time show the nodule size has remain unchanged for 2 years, it is generally considered benign.

A chest CT scan is often done to look at a solitary pulmonary nodule in more detail.

Other tests used to examine a solitary pulmonary nodule may include:

  • PET scan
  • Percutaneous needle biopsy
  • Single-photon emission CT (SPECT) scan
  • Skin tests to rule out infectious causes
  • Lung biopsy


Treatment:

Ask your doctor about the risks of a biopsy versus monitoring the size of the nodule with regular x-rays.

Reasons for a biopsy or removing the nodule may include:

  • Smoking
  • The nodule size has grown compared to earlier x-rays
  • A CT scan suggests the lesion is malignant (cancerous)


Support Groups:



Expectations (prognosis):

The outlook is generally good if the nodule is benign. If the nodule does not grow larger over a 2-year period, under most circumstances nothing more need be done. On occasion, the appearance of the nodule on CT scan may warrant continued follow-up.



Calling your health care provider:

A solitary pulmonary nodule is usually found by your health care professional when a chest x-ray is performed for some other reason.



Prevention:



References:

Cronin P, Dwamena BA, Kelly AM, Carlos RC. Solitary pulmonary nodules: meta-analytic comparison of cross-sectional imaging modalities for diagnosis of malignancy. Radiology. 2008 Mar;246(3):772-82.

Gould MK, Fletcher J, Iannettoni MD, et al. Evaluation of patients with pulmonary nodules: when is it lung cancer?: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132:108S-130S.

Wahidi MM, Govert JA, Goudar RK, et al. Evidence for the treatment of patients with pulmonary nodules: when is it lung cancer?: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132:94S-107S.




Review Date: 8/17/2009
Reviewed By: Allen J. Blaivas, DO, Clinical Assistant Professor of Medicine UMDNJ-NJMS, Attending Physician in the Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Veteran Affairs, VA New Jersey Health Care System, East Orange, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
Toll free: 1 (877) 201-7100