Lung nodules are small masses of tissue in the lung that appear as spots on an X-ray or CT scan of the chest that may or may not be cancer-causing. With the increase in the use of CT scans, lung nodules are being found with increasing regularity, though people with solitary lung nodules do not usually experience symptoms.
Nodules are characterized based upon their size, density and shape. Small and smooth nodules are more likely to be benign, while nodules that are more likely to be cancerous are those with irregular borders, mixed densities or are growing over time.
Benign – noncancerous – pulmonary lung nodules require no treatment. Cancerous lung nodules, however, usually are surgically removed. The procedures used depend on the size, condition and location of the nodule.
Observation with repeat CT scans in three to six months may be recommended. If this is the case, the patient will be given a prescription with a date for a repeat comparison study, and then will be required to return to review both the older and more recent scans. This will determine if the nodule has changed in size or shape. Sometimes removal of a nodule because of suspicion of cancer is necessary.
In many cases, a minimally invasive approach to remove the nodules can be used, which means the spot can often be removed with only a limited amount of lung tissue. Hospital stay is quite brief in many cases, and for most patients, surgery and removal of the nodule is the only treatment necessary.
Lung cancer screening uses low-dose computed tomography (CT) scans with reduced radiation to identify lung nodules. CT or CAT (computerized axial tomography) scans are more likely to show lung tumors than routine chest X-rays are. A CT scan can provide precise information about the size, shape and position of lung tumors and can help find enlarged lymph nodes that might contain cancer that has spread from the lung.
If your scan shows a lung nodule your doctor may recommend a follow-up CT scan (generally in six months) to check that the nodule hasn’t grown. In the unlikely case that it does grow, or is otherwise concerning, your doctor may recommend further testing using a PET/CT scan or a biopsy (removal of nodule tissue to be examined by a pathologist). However, since more than 95 percent of lung nodules are not cancerous, you probably will be asked to return in 12 months to continue the screening process.