Pulmonary nodule overview: Difference between revisions
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==Overview== | ==Overview== | ||
'''Solitary pulmonary nodule (SPN)''' is defined as a relatively well defined round or oval pulmonary parenchymal lesion equal or smaller than 30 mm in diameter. Solitary pulmonary nodule is usually surrounded by pulmonary parenchyma and/or visceral pleura and is not associated with lymphadenopathy, atelectasis, or pneumonia. In the majority of the cases, solitary pulmonary nodule can be encountered as a [[incidentaloma|incidental finding]] found in up to 0.2% of [[chest X-ray]]s and around 1% of [[CT scan]]s.<ref name="NEJM-cp">{{cite journal |author=Ost D, Fein AM, Feinsilver SH |title=Clinical practice. The solitary pulmonary nodule |journal=N. Engl. J. Med. |volume=348 |issue=25 |pages=2535–42 |year=2003 |month=June |pmid=12815140 |doi=10.1056/NEJMcp012290 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=12815140&promo=ONFLNS19}}</ref><ref name="pmid18402653">{{cite journal |author=Alzahouri K, Velten M, Arveux P, Woronoff-Lemsi MC, Jolly D, Guillemin F |title=Management of SPN in France. Pathways for definitive diagnosis of solitary pulmonary nodule: a multicentre study in 18 French districts |journal=BMC Cancer |volume=8 |issue= |pages=93 |year=2008 |pmid=18402653 |pmc=2373300 |doi=10.1186/1471-2407-8-93 |url=http://www.biomedcentral.com/1471-2407/8/93}}</ref> The nodule most commonly represents a [[benign]] tumor, such as a [[granuloma]] or [[hamartoma]], but in around 20% of cases it represents a [[malignant]] [[cancer]].<ref name="pmid18402653">{{cite journal |author=Alzahouri K, Velten M, Arveux P, Woronoff-Lemsi MC, Jolly D, Guillemin F |title=Management of SPN in France. Pathways for definitive diagnosis of solitary pulmonary nodule: a multicentre study in 18 French districts |journal=BMC Cancer |volume=8 |issue= |pages=93 |year=2008 |pmid=18402653 |pmc=2373300 |doi=10.1186/1471-2407-8-93 |url=http://www.biomedcentral.com/1471-2407/8/93}}</ref> Approximately 10 to 20% of patients with [[lung cancer]] are diagnosed this way.<ref name="pmid18402653"/> Thus, the possibility of cancer needs to be excluded through further radiological studies and interventions, possibly including surgical resection. The [[prognosis]] depends on the underlying condition. | '''Solitary pulmonary nodule (SPN)''' is defined as a relatively well defined round or oval pulmonary parenchymal lesion equal or smaller than 30 mm in diameter. Solitary pulmonary nodule is usually surrounded by pulmonary parenchyma and/or visceral pleura and is not associated with lymphadenopathy, atelectasis, or pneumonia. In the majority of the cases, solitary pulmonary nodule can be encountered as a [[incidentaloma|incidental finding]] found in up to 0.2% of [[chest X-ray]]s and around 1% of [[CT scan]]s.<ref name="NEJM-cp">{{cite journal |author=Ost D, Fein AM, Feinsilver SH |title=Clinical practice. The solitary pulmonary nodule |journal=N. Engl. J. Med. |volume=348 |issue=25 |pages=2535–42 |year=2003 |month=June |pmid=12815140 |doi=10.1056/NEJMcp012290 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=12815140&promo=ONFLNS19}}</ref><ref name="pmid18402653">{{cite journal |author=Alzahouri K, Velten M, Arveux P, Woronoff-Lemsi MC, Jolly D, Guillemin F |title=Management of SPN in France. Pathways for definitive diagnosis of solitary pulmonary nodule: a multicentre study in 18 French districts |journal=BMC Cancer |volume=8 |issue= |pages=93 |year=2008 |pmid=18402653 |pmc=2373300 |doi=10.1186/1471-2407-8-93 |url=http://www.biomedcentral.com/1471-2407/8/93}}</ref> The nodule most commonly represents a [[benign]] tumor, such as a [[granuloma]] or [[hamartoma]], but in around 20% of cases it represents a [[malignant]] [[cancer]].<ref name="pmid18402653">{{cite journal |author=Alzahouri K, Velten M, Arveux P, Woronoff-Lemsi MC, Jolly D, Guillemin F |title=Management of SPN in France. Pathways for definitive diagnosis of solitary pulmonary nodule: a multicentre study in 18 French districts |journal=BMC Cancer |volume=8 |issue= |pages=93 |year=2008 |pmid=18402653 |pmc=2373300 |doi=10.1186/1471-2407-8-93 |url=http://www.biomedcentral.com/1471-2407/8/93}}</ref> Approximately 10 to 20% of patients with [[lung cancer]] are diagnosed this way.<ref name="pmid18402653"/> Thus, the possibility of cancer needs to be excluded through further radiological studies and interventions, possibly including surgical resection. The [[prognosis]] depends on the underlying condition. | ||
==Classification== | ==Classification== | ||
According to the Fleischner society, solitary pulmonary nodules can be classified according to size, morphology, and/or distribution. | According to the Fleischner society, solitary pulmonary nodules can be classified according to size, morphology, and/or distribution. | ||
==Causes== | ==Causes== | ||
==Differentiating Solitary Pulmonary Nodule from | ==Differentiating Solitary Pulmonary Nodule from Other Diseases== | ||
==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
==Screening== | ==Screening== | ||
According to the the U.S. Preventive Service Task Force (USPSTF), there is insufficient evidence to recommend routine screening for solitary pulmonary nodule.<ref name="US">Recommendations. US preventive services task force(2016) http://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=solitary_pulmonary_nodule Accessed on March, 15th 2016</ref> | According to the the U.S. Preventive Service Task Force (USPSTF), there is insufficient evidence to recommend routine screening for solitary pulmonary nodule.<ref name="US">Recommendations. US preventive services task force(2016) http://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=solitary_pulmonary_nodule Accessed on March, 15th 2016</ref> | ||
==Diagnosis== | ==Diagnosis== | ||
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===Laboratory Findings=== | ===Laboratory Findings=== | ||
=== | ===Imaging=== | ||
===Other Diagnostic Studies=== | ===Other Diagnostic Studies=== | ||
==Treatment== | ==Treatment== | ||
=== | ===Therapeutic Management=== | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Pulmonology]] | [[Category:Pulmonology]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
{{WikiDoc Help Menu}} | {{WikiDoc Help Menu}} | ||
{{WikiDoc Sources}} | {{WikiDoc Sources}} |
Revision as of 13:48, 15 March 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Overview
Solitary pulmonary nodule (SPN) is defined as a relatively well defined round or oval pulmonary parenchymal lesion equal or smaller than 30 mm in diameter. Solitary pulmonary nodule is usually surrounded by pulmonary parenchyma and/or visceral pleura and is not associated with lymphadenopathy, atelectasis, or pneumonia. In the majority of the cases, solitary pulmonary nodule can be encountered as a incidental finding found in up to 0.2% of chest X-rays and around 1% of CT scans.[1][2] The nodule most commonly represents a benign tumor, such as a granuloma or hamartoma, but in around 20% of cases it represents a malignant cancer.[2] Approximately 10 to 20% of patients with lung cancer are diagnosed this way.[2] Thus, the possibility of cancer needs to be excluded through further radiological studies and interventions, possibly including surgical resection. The prognosis depends on the underlying condition.
Classification
According to the Fleischner society, solitary pulmonary nodules can be classified according to size, morphology, and/or distribution.
Causes
Differentiating Solitary Pulmonary Nodule from Other Diseases
Epidemiology and Demographics
Screening
According to the the U.S. Preventive Service Task Force (USPSTF), there is insufficient evidence to recommend routine screening for solitary pulmonary nodule.[3]
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Imaging
Other Diagnostic Studies
Treatment
Therapeutic Management
References
- ↑ Ost D, Fein AM, Feinsilver SH (2003). "Clinical practice. The solitary pulmonary nodule". N. Engl. J. Med. 348 (25): 2535–42. doi:10.1056/NEJMcp012290. PMID 12815140. Unknown parameter
|month=
ignored (help) - ↑ 2.0 2.1 2.2 Alzahouri K, Velten M, Arveux P, Woronoff-Lemsi MC, Jolly D, Guillemin F (2008). "Management of SPN in France. Pathways for definitive diagnosis of solitary pulmonary nodule: a multicentre study in 18 French districts". BMC Cancer. 8: 93. doi:10.1186/1471-2407-8-93. PMC 2373300. PMID 18402653.
- ↑ Recommendations. US preventive services task force(2016) http://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=solitary_pulmonary_nodule Accessed on March, 15th 2016