Pulmonary nodule classification

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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

Pulmonary nodule may be classified according to size (> 8 mm vs. ≤8 mm), attenuation (pure solid vs. part-solid), and distribution (solitary vs. multiple). It can also be classified into benign and malignant based on the radiological findings.

Classification

Based on size, attenuation, and distribution

Pulmonary nodule may be classified according to size, attenuation, and distribution into the following:

Size

• Nodules measuring >8 mm and < 30 mm in diameter
• Nodules measuring ≤8 mm in diameter

Attenuation

• Pure solid nodules
• Part-solid nodules

Distribution

• Solitary pulmonary nodule
• Multiple pulmonary nodules

Based on Radiological Findings

The table below summarizes the radiological features suggestive of benign or malignant pulmonary nodules.

Radiologic Features Suggestive of Benign or Malignant Pulmonary Nodules Adapted from American Academy of Family Physicians
Radiologic feature	Benign	Malignant
Size	< 5 mm	> 10 mm
Border	Smooth	Irregular or spiculated
Density	Dense, solid	Nonsolid, “ground glass”
Calcification	Typically a benign feature, especially in “concentric,” “central,” “popcorn-like,” or “homogeneous” patterns	Typically noncalcified, or “eccentric” calcification
Doubling time	Less than one month; more than one year	One month to one year