Definition

Pulmonary nodules are typically 3 cm (approximately 1 inch) or smaller areas of shadowing in the lung. They are visible on a body scan (CT scan) and occasionally on a chest-X-rays.

Aetiology

  • Common findings but generally speaking, individuals are asymptomatic. 

  • Most are benign, might be caused by scarring from lung infection e.g tuberculosis (TB) or rheumatoid arthritis (RA).

Pathophysiology

Can be inflammatory of malignant nodules. 

  1. Inflammatory: can be caused by an infection or noninfectious inflammation. 

  2. Malignant: Non-Small Cell Lung Cancer (NSCLC) or Small Cell Lung Cancer (SCLC). These are generally caused by a genetic mutation which causes abnormal cell growth causing lung cancer.

Risk factors

  • Smoking. 

  • Age: more common in over 40s. 

  • Occupation: e.g mining, construction, asbestos handling. 

  • Individual and/or family history of pulmonary nodules. 

  • Immunocompromised. 

  • Genetic factors.

Sign and symptoms

  • Shortness of Breath (Dyspnea).

  • Chest Pain.

  • Weight loss. 

  • Unexplained weight loss.

Diagnosis and investigations

  • CT scan. 

  • Chest X-ray.

  • PET-CT Scan.

Management

  • If asymptomatic regular monitoring. 

  • If caused by infection e.g TB or a fungal infection, antibiotics or antifungal therapy will be commenced. 

  • If suspicious of malignancy: biopsy + consideration of surgery. 

  • If cancer is diagnosed: chemo/radiotherapy.

 
 
 

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