open access

Vol 85, No 6 (2017)
REVIEWS
Published online: 2017-12-14
Submitted: 2017-09-07
Accepted: 2017-10-30
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Solitary pulmonary nodule — the role of imaging in the diagnostic process

Marcin Paśnik, Iwona Bestry, Kazimierz Roszkowski - Śliż
DOI: 10.5603/ARM.2017.0059
·
Adv Respir Med 2017;85(6):345-351.

open access

Vol 85, No 6 (2017)
REVIEWS
Published online: 2017-12-14
Submitted: 2017-09-07
Accepted: 2017-10-30

Abstract

A solitary pulmonary nodule is a round opacity less than 30 mm in diameter surrounded by normally aerated lung tissue. Determination of the character of the lesion following its detection (particularly when the identification was incidental) may require a complex diagnostic process. In most cases, nodules are benign in character; however, the probability of malignancy increases significantly for part-solid lesions. The main features that describe the solitary pulmonary nodule in computed tomography scans include their size, shape, density, presence of calcification and rate of growth. PET-CT examination provides additional information on the metabolic activity of the lesions, and MRI is helpful in assessment of local invasion of surrounding structures. Due to limited availability and highly specialized character, these examinations are not routinely used. Therefore, despite development of other imaging modalities, computed tomography remains the most important and crucial diagnostic tool. Clinical risk factors such as age or smoking status are very important for evaluation of the likelihood of malignancy of a nodular lesion. Due to the multidisciplinary nature of data required for complex assessment of a solitary nodular lesion, management routines are needed in the diagnostic process such as those proposed by the Fleischner Society.

Abstract

A solitary pulmonary nodule is a round opacity less than 30 mm in diameter surrounded by normally aerated lung tissue. Determination of the character of the lesion following its detection (particularly when the identification was incidental) may require a complex diagnostic process. In most cases, nodules are benign in character; however, the probability of malignancy increases significantly for part-solid lesions. The main features that describe the solitary pulmonary nodule in computed tomography scans include their size, shape, density, presence of calcification and rate of growth. PET-CT examination provides additional information on the metabolic activity of the lesions, and MRI is helpful in assessment of local invasion of surrounding structures. Due to limited availability and highly specialized character, these examinations are not routinely used. Therefore, despite development of other imaging modalities, computed tomography remains the most important and crucial diagnostic tool. Clinical risk factors such as age or smoking status are very important for evaluation of the likelihood of malignancy of a nodular lesion. Due to the multidisciplinary nature of data required for complex assessment of a solitary nodular lesion, management routines are needed in the diagnostic process such as those proposed by the Fleischner Society.
Get Citation

Keywords

solitary pulmonary nodule; non-solid nodule; management strategy; chest imaging; lung neoplasms

About this article
Title

Solitary pulmonary nodule — the role of imaging in the diagnostic process

Journal

Advances in Respiratory Medicine

Issue

Vol 85, No 6 (2017)

Pages

345-351

Published online

2017-12-14

DOI

10.5603/ARM.2017.0059

Bibliographic record

Adv Respir Med 2017;85(6):345-351.

Keywords

solitary pulmonary nodule
non-solid nodule
management strategy
chest imaging
lung neoplasms

Authors

Marcin Paśnik
Iwona Bestry
Kazimierz Roszkowski - Śliż

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