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Solitary pulmonary nodule

Show Alternative Names
Lung cancer - solitary nodule
Infectious granuloma - pulmonary nodule
SPN

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

Causes

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

Infectious granulomas (which are formed by cells as a reaction to a past infection) cause most benign lesions. Common infections that often result in granulomas or other healed scars include:

Primary lung cancer is the most common cause of cancerous (malignant) pulmonary nodules. This is cancer that starts in the lung.

Symptoms

A solitary pulmonary nodule itself rarely causes symptoms.

Exams and Tests

A solitary pulmonary nodule is most often found on a chest x-ray or chest CT scan. These imaging tests are often done for other symptoms or reasons.

Your health care provider must decide whether the nodule in your lung is most likely benign or of concern. A nodule more is likely benign if:

  • The nodule is small, has a smooth border, and has a solid and even appearance on an x-ray or CT scan.
  • You are young and do not smoke.

Your provider may then choose to monitor the nodule over time by repeating a series of x-rays or CT scans.

  • Repeat chest x-rays or chest CT scans are the most common way to monitor the nodule. Sometimes, lung PET scans may be done.
  • If repeated x-rays show that the nodule size has not changed in 2 years, it is most likely benign and a biopsy is not needed.

Your provider may choose to biopsy the nodule to rule out cancer if:

  • You are a smoker.
  • You have other symptoms of lung cancer.
  • The nodule has grown in size or has changed when compared to earlier images.

A lung needle biopsy may be done by placing a needle directly through the wall of your chest, or during procedures called bronchoscopy or mediastinoscopy.

Tests to rule out TB and other infections may also be done.

Treatment

Ask your provider about the risks of having a biopsy versus monitoring the size of the nodule with regular x-rays or CT scans. Treatment may be based on the results of the biopsy or other tests.

Outlook (Prognosis)

The outlook is usually good if the nodule is benign. If the nodule does not grow larger over a 2-year period, often nothing more needs to be done.

Text only

Review Date: 7/19/2021

Reviewed By

Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

References

Bueno J, Landeras L, Chung JH. Updated Fleischner Society guidelines for managing incidental pulmonary nodules: common questions and challenging scenarios. Radiographics. 2018;38(5):1337-1350. PMID: 30207935 pubmed.ncbi.nlm.nih.gov/30207935/.

Jokerst CE, Gotway MB. Thoracic radiology: noninvasive diagnostic imaging. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 20.

Reed JC. Solitary pulmonary nodule. In: Reed JC, ed. Chest Radiology: Patterns and Differential Diagnoses. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 20.

Disclaimer

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. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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Adenocarcinoma - chest x-ray - Illustration Thumbnail

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This chest x-ray shows adenocarcinoma of the lung. There is a rounded light spot in the right upper lung (left side of the picture) at the level of the second rib. The light spot has irregular and poorly defined borders and is not uniform in density. Diseases that may cause this type of x-ray result would be tuberculous or fungal granuloma, and malignant or benign tumors.

Illustration

Pulmonary nodule - front view chest x-ray - Illustration Thumbnail

Pulmonary nodule - front view chest x-ray

This x-ray shows a single lesion (pulmonary nodule) in the upper right lung (seen as a light area on the left side of the picture). The nodule has distinct borders (well-defined) and is uniform in density. Tuberculosis (TB) and other diseases can cause this type of lesion.

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Pulmonary nodule, solitary - CT scan - Illustration Thumbnail

Pulmonary nodule, solitary - CT scan

This CT scan shows a single lesion (pulmonary nodule) in the right lung. This nodule is seen as the light circle in the upper portion of the dark area on the left side of the picture. A normal lung would look completely black in a CT scan.

Illustration

Respiratory system - Illustration Thumbnail

Respiratory system

Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

Illustration

 
 
 
 

 

 
 

 
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