Pulmonary nodules may be a sign of lung cancer or another lung condition that isn’t cancerous. These growths are among the abnormalities our doctors evaluate in the Lung Cancer Early Detection and Prevention Clinic, and they sometimes lead to a lung cancer diagnosis.
What is a pulmonary nodule?
A pulmonary nodule is a small, roundish growth on the lung that measures three centimeters in diameter or less. Most pulmonary nodules are extremely small, less than one centimeter across.
If the growth is larger than three centimeters, it is called a pulmonary mass.
Though pulmonary nodules may grow to become a pulmonary mass, some nodules may not grow at all.
What causes pulmonary nodules?
There are many causes of pulmonary nodules, including:
- Infections, such as fungal or bacterial infections
- Noncancerous processes, such as sarcoidosis
- Cancerous processes, such as lung cancer, lymphoma or cancer that has spread from other organs
The likelihood that a pulmonary nodule is lung cancer depends on:
- Your age
- Your smoking history
- Your history of exposure to environmental risk factors
Generally, less than 1 in 10 pulmonary nodules turns out to be lung cancer.
Symptoms of pulmonary nodules
Because pulmonary nodules are small, they rarely cause any symptoms. Some people might experience symptoms of a respiratory infection, such as a chest cold or mild flu.
Most pulmonary nodules are discovered by accident, when a patient gets a chest X-ray or a computed tomography (CT) scan for some other reason.
Evaluating a pulmonary nodule
The immediate goal of evaluating a pulmonary nodule is to determine its potential to be cancerous. Your doctor will ask about your personal and medical history and your environmental-exposure history, and you may have a chest CT scan.
If your doctor thinks you have a nodule with significant cancer potential and the nodule is one centimeter across or larger, they will use diagnostic procedures to determine the cause of the nodule.
There are many noninvasive or minimally invasive methods, such as:
- Positron emission tomography (PET) scans
- Endobronchial ultrasound
- CT-guided needle biopsy
- Biopsy guided by fluoroscopy (moving X-ray)
If your pulmonary nodule cannot be diagnosed using one of these approaches, you may need surgery, such as:
- Video-assisted thoracic surgery, done through a series of small incisions using a scope with a camera to see inside your chest
- Open-chest surgery (thoracotomy)
- Mini-thoracotomy (open-chest surgery with a smaller incision)
Once your doctor knows the cause of your pulmonary nodule, they can recommend a treatment plan tailored to you. If you are diagnosed with lung cancer, learn more about lung cancer treatment.
Following a pulmonary nodule
Most pulmonary nodules are too small (less than one centimeter across) to be diagnosed safely and accurately using any of the procedures or tests currently available. Because these very small pulmonary nodules can represent early lung cancer, they need to be followed closely using CT scans to evaluate whether they grow over time. If the size of these nodules doesn’t change for two years, the chance that they represent lung cancer is very small.
Request an appointment
If you have been diagnosed with a pulmonary nodule or other abnormality that might be a sign of lung cancer, request an appointment for an evaluation at the Lung Cancer Early Detection and Prevention Clinic by calling (206) 606-6100.