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Solitary pulmonary nodule

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Illustrations

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    Return to top

A solitary pulmonary nodule is a round or oval, sharply defined lung lesion seen on a chest x-ray.

Causes, incidence, and risk factors    Return to top

About 60% of all solitary pulmonary nodules are benign (not cancerous). Benign nodules have many causes, including old scars and infections.

Infectious granulomas (inflammations of granular tissue) are the cause of most benign lesions. When a nodule is malignant, lung cancer is the most common cause. Exposure to tuberculosis or an infectious fungus (histoplasmosis, coccidioidomycosis) can increase the risk of developing a solitary pulmonary nodule, but also makes it more likely that the nodule is benign.

Young age, absence of tobacco exposure, calcium in the lesion, and small lesion size are factors favoring a benign diagnosis. About 150,000 new solitary pulmonary nodules are diagnosed each year in the United States. Of these, 45,000 require no further testing besides a careful history and review of an old chest x-ray, if available.

Symptoms    Return to top

There are usually no symptoms.

Signs and tests    Return to top

A solitary pulmonary nodule is usually found on a chest x-ray. If serial chest x-rays (repeated x-rays over time) show the nodule size unchanged for 2 years, it is considered benign. A chest CT scan is often performed to evaluate a solitary pulmonary nodule in detail.

Other tests may include the following:

Treatment    Return to top

Most nodules in patients over 35 years old should be considered potentially malignant until proven otherwise. If the lesion is suspected to be benign, serial chest x-rays or CT scans may be taken on a regular basis for observation of the lesion. If the affected person is at high risk for lung cancer or if the CT scan appearance of the lesion suggests it is malignant, surgical removal of the lesion (excisional biopsy) is recommended.

Expectations (prognosis)    Return to top

The outlook is generally good if the nodule is benign.

Complications    Return to top

The nodule could be due to a malignancy, including lung cancer.

Calling your health care provider    Return to top

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

Update Date: 5/27/2004

Updated by: Allen J. Blaivas, D.O., Division of Pulmonary, Critical Care, and Sleep Medicine, University Hospital, Newark, NJ. Review provided by VeriMed Healthcare Network.

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