Solitary pulmonary nodule

Last revised by Nikolaos-Achilleas Arkoudis on 2 Feb 2024

Solitary pulmonary nodule (SPN) is defined as a relatively well-defined round or oval pulmonary parenchymal lesion equal to or smaller than 30 mm in diameter. It is surrounded by pulmonary parenchyma and/or visceral pleura and is not associated with lymphadenopathy, atelectasis, or pneumonia 9.

Questions to ask when you approach a solitary pulmonary nodule:

  • is the lesion solitary?

  • is it intrapulmonary?

  • is the lesion a nodule?

    • should be a discrete round/oval opacity 4-30 mm in diameter; a lesion >30 mm is defined as a mass, not a nodule

    • should not be linear or angular

  • is the lesion detected in an adult or a child?

    • The detection of an SPN in a child necessitates a distinct approach compared to identifying one in an adult10.

    • The differential diagnosis of an SPN in children is wide and may include congenital, infectious, inflammatory, neoplastic, vascular etiologies etc10.

    • For children, utilizing the adult guidelines established by the Fleischner Society is not appropriate10,11,12.

There are many causes of solitary pulmonary nodule, including:

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