Pulmonary Nodules: Detection and Risk Evaluation

Abstract

Pulmonary nodules can be defined as round/irregular opacities no larger than 3 cm and may represent an incidental finding during CT exams (prevalence of 8–51% in different studies). Incidental and undetermined solid non-calcific pulmonary nodules have a relatively low malignancy rate; nevertheless, their evaluation is a matter of great interest in clinical management, since it is based on the detection of subjects with malignant lesions that can have potentially complete benefits from surgical treatment, or on the avoidance of invasive procedures in patients with benign lesions. In fact, several options are available in the management of an undetermined incidental pulmonary nodule, and the most appropriate choice depends on a careful evaluation of patient’s risk factors and of the characteristics of the nodule.

This chapter provides a brief review of all the main features of pulmonary nodules that need to be analyzed in order to establish a potential malignant nature (dimension, morphology and position, density, growth); following that, it illustrates a practical guide for the management of both single and multiple pulmonary nodules, depending on their dimension and patient’s risk factors. Finally, the main malignant causes of multiple pulmonary nodules are described.