What are Pulmonary Nodules?

What are Pulmonary Nodules?

A pulmonary nodule is a small oval or round shaped lump in the lungs that is typically benign. They are also known as “spots” in the lungs.  These small growths are just over an inch in diameter or smaller, otherwise, it is called a pulmonary mass and is more likely to be cancerous.

How Common are Pulmonary Nodules?

CT scans and chest x-rays reveal a countless number of pulmonary nodules each year.  Nodules in the lungs can be found on up to 50% of CT scans. Those that are older in age and have a history of smoking are more at risk for pulmonary nodules.

Pulmonary Nodule Causes

There are a number of causes for pulmonary nodules.  Most are because of inflammation in the lungs because of diseases or infection.  The nodule can be from scar tissue because of a past issue or it can be a result of an active ailment.
Infectious Causes — Diseases such as Mycobacterium tuberculosis or Mycobacterium avium intracellular, and fungal infections can result in pulmonary nodules.  

Noninfectious Causes — Conditions like sarcoidosis, GPA, and rheumatoid arthritis can cause nodules in the lungs.

Pulmonary Nodule Symptoms

More often than not, there are no symptoms associated with nodules.  Typically the only symptoms a person experiences are symptoms related to why the person developed the nodules.  For example, if a person has a pulmonary nodule from lung cancer, s/he does not have symptoms of the nodule, but has a cough and/or is coughing up blood.  Most often, it is only when a lung CT scan or chest x-ray is performed that the presences of a nodule is known.

Diagnosing Pulmonary Nodules

As previously mentioned, a pulmonary nodule presence is typically not known until it shows on a CT scan or chest x-ray.  A person will see their doctor for a respiratory illness and that spot will show on the CT scan or chest x-ray. To check whether or not the nodule is malignant, a PET (positron emission tomography) scan will be performed.  Using a radio-labeled substance, the nodules can light up on the PET image if it cancerous. A biopsy of the nodule may be performed to gather further information.

Pulmonary Nodule Treatment

Most pulmonary nodules are not malignant, but those that are cancerous are curable early in their development.  So it is important that those are identified early on. If the nodule is benign, it typically doesn’t need treatment.  If the nodule is malignant and the spread of cancer doesn't seem to be present, the nodule should be removed surgically.  There are two types of surgical techniques to remove pulmonary nodules: thoracotomy and video-assisted thoracoscopy. Thoracotomy is considered to be open lung surgery.  The mortality risk with this procedure is low and requires a few days stay at the hospital. Video-assisted thoracoscopy uses a flexible tube with a tiny camera attached to the end.  The camera is inserted into a small incision in the chest and allows the surgeon to view the nodule on a screen. This requires less downtime than a thoracotomy.

Pulmonary Nodule Prevention

The best thing to do to avoid developing a malignant pulmonary nodule is to quit smoking if you smoke.