Understanding of lung nodule

What’s a lung nodule?

A lung nodule is a round-like white shadow in the lung, less than 30mm in size on imaging.

A lung nodule rarely causes signs or symptoms. It is often detected by chance during chest imaging for other unrelated medical problems.

You do not need to be nervous if you have one or more lung nodules, as over 90% are harmless and only a small percentage are cancerous.

A variety of causes can lead to a nodule in the lung, but a few may be early lung cancer, particularly in people with high-risk factors such as old age, smoking, etc. It is, therefore, necessary for you to have a risk assessment.

How to evaluate and diagnose a lung nodule?

Doctors can evaluate the risk of a lung nodule, to see if it is cancerous and, if so, at what stage, based on its shape, size, and characteristics. Then a decision can be made on further treatment options.

Doctors often use the following diagnostic methods：

Chest CT scan: the first choice for examining and following up lung nodules.
Chest x-ray: less accurate for small nodules, which can be missed, and therefore less commonly used.
PET scan: to check if a nodule is cancerous and, if so, whether it has spread elsewhere in the body. However, it’s not suitable for small nodules and is expensive.
Non-surgical biopsy: a small bit of tissue is taken from the nodule for testing, either by bronchoscopy or percutaneous lung puncture.
Surgical biopsy: a biopsy is taken during surgery, and if the nodule is clearly diagnosed as cancerous, complete resection is then performed.

What to do with a non-cancerous nodule?

If a lung nodule is non-cancerous, it can be caused by infection, inflammation, or other benign lesions, or it may be a scar left after a previous lesion has healed.

Most cases can be treated without treatment, or just given anti-infective or anti-inflammatory medication. Whether or not treatment is given, the doctor will usually recommend a period of follow-up.

What to do with a malignant nodule?

If the nodule is malignant, it means it is early lung cancer. Your thoracic surgeon will decide on the best treatment depending on your specific condition. Minimally invasive resection is the most used, with other options such as open surgery, radiotherapy, or chemotherapy.

Fortunately, the vast majority of malignant nodules are very early and will have a good outcome when treated.

So there is no need to panic if a nodule is malignant, just be in a good mood and discuss the proper treatment options with your surgeon.

Is follow-up important?

Doctors often recommend follow-up monitoring for lung nodules.

For non-cancerous nodules, surgery is usually not necessary and follow-up is usually recommended to see if they change over time. For cancerous nodules, the results of the surgery need to be monitored after they have been removed, and if new nodules develop they can be observed. Therefore, careful follow-up is important. This is done by regular CT scans at intervals of a few months to one year.