Pulmonary nodules are small, rounded opacities within the pulmonary interstitium. Pulmonary nodules are common and, as the spatial resolution of CT scanners has increased, detection of smaller and smaller nodules has occurred, which are more often an incidental finding.
Pulmonary nodules can be classified according to size, morphology and/or distribution.
Size
Morphology
Distribution
They are generally homogeneous (without air bronchograms or alveolograms) and are well-defined since their margins are sharp and they are surrounded by normal aerated lung. They are quite separate from airspace nodules that often have an irregular margin and are usually ~8 mm in diameter. (For further discussion, see the article on nodular opacification.)
The differential diagnosis for a nodule can be refined by its size, location, and density. Solitary pulmonary nodules and hyperdense pulmonary nodules are discussed further elsewhere.
A micronodular or miliary pattern is predominately seen in granulomatous processes, haematogenous pulmonary metastases, and pneumoconioses. Nodules and masses are most often seen in metastatic disease to the lung.
Always be aware of artifacts, especially on radiographs, where buttons or nipple shadows can often be mistaken for a true pulmonary nodule 7.
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- 1. Boitsios G, Bankier AA, Eisenberg RL. Diffuse pulmonary nodules. AJR Am J Roentgenol. 2010;194 (5): W354-66. AJR Am J Roentgenol (full text) - doi:10.2214/AJR.10.4345 - Pubmed citation
- 2. Macmahon H, Austin JH, Gamsu G et-al. Guidelines for management of small pulmonary nodules detected on CT scans: a statement from the Fleischner Society. Radiology. 2005;237 (2): 395-400. Radiology (full text) - doi:10.1148/radiol.2372041887 - Pubmed citation
- 3. Prosch H, Strasser G, Oschatz E et-al. Management of patients with small pulmonary nodules: a survey of radiologists, pulmonologists, and thoracic surgeons. AJR Am J Roentgenol. 2006;187 (1): 143-8. doi:10.2214/AJR.05.1229 - Pubmed citation
- 4. Gould MK, Donington J, Lynch WR et-al. Evaluation of individuals with pulmonary nodules: when is it lung cancer? Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143 (5_suppl): e93S-120S. doi:10.1378/chest.12-2351 - Free text at pubmed - Pubmed citation
- 5. Snoeckx A, Reyntiens P, Desbuquoit D, Spinhoven MJ, Van Schil PE, van Meerbeeck JP, Parizel PM. Evaluation of the solitary pulmonary nodule: size matters, but do not ignore the power of morphology. (2018) Insights into imaging. 9 (1): 73-86. doi:10.1007/s13244-017-0581-2 - Pubmed
- 6. Raad RA, Suh J, Harari S, Naidich DP, Shiau M, Ko JP. Nodule characterization: subsolid nodules. (2014) Radiologic clinics of North America. 52 (1): 47-67. doi:10.1016/j.rcl.2013.08.011 - Pubmed
- 7. Dr Stephen Ellis. Interpreting Chest X Rays. (2010) ISBN: 9781904842774
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