Physical Address
304 North Cardinal St.
Dorchester Center, MA 02124
Solitary Pulmonary Nodule
1
Does lung cancer screening save lives?
The United States National Lung Screening Trial (NLST) reported a reduction in lung cancer mortality of 20%, and a 6.7% decrease in all-cause mortality. Low-dose computed tomography (CT) scans may prove beneficial in high-risk patients. Multiple other screening trials have not proven to be so optimistic; lung screening remains controversial.
2
What is a solitary pulmonary nodule?
A solitary pulmonary nodule or “coin lesion” is found on chest radiograph, or CT, and is <3 cm. It is completely surrounded by lung parenchyma.
3
What causes a solitary pulmonary nodule?
The most common causes of a pulmonary nodule are either neoplastic (carcinoma, 60%–70% of resected nodules) or infectious (granuloma). Pulmonary nodules may also represent lung abscess, pulmonary infarction, arteriovenous malformations, resolving pneumonia, pulmonary sequestration, and hamartoma. As a general rule of thumb, likelihood of malignancy is proportionate to the nodule’s size, the patient’s age, and history of smoking. Thus, whereas lung cancer is rare (although it does occur) in 30-year-old individuals, in 50-year-old smokers the chance that a solitary pulmonary nodule represents malignancy is 50%–60%. In a 70-year-old person with a smoking history and a 2.9-cm pulmonary nodule the malignancy risk is 75%.
4
How does a solitary pulmonary nodule present?
Typically, a solitary nodule presents incidentally as a finding on routine chest radiograph. In several large series, more than 75% of lesions were surprise findings on routine chest radiograph. Fewer than 25% of patients had symptoms referable to the lung. Solitary nodules are now seen on other sensitive imaging tests such as helical CT.
You're Reading a Preview
Become a Clinical Tree membership for Full access and enjoy Unlimited articles
If you are a member. Log in here