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Pulmonary Nodules—an Epidemic—Work Up and Management, Specific, and Unique Issues in the Elderly

  • Pulmonology and Respiratory Care (D Breen, Section Editor)
  • Published:
Current Geriatrics Reports Aims and scope Submit manuscript

Abstract

Purpose of the Review

Pulmonary nodules are increasingly encountered by physicians with the increasing use of, and easier access to computerised tomography for the investigation of a variety of conditions. With the wider introduction of lung cancer screening using low dose CT, it is likely that the number of patients with pulmonary nodules will significantly increase. The main challenge in pulmonary nodules investigations and management is the differentiation of benign from a malignant aetiology. There are also certain considerations in the elderly population.

Recent Findings

A reliable assessment of the risk of lung cancer is required, and guidelines were devised based on a plethora of evidence to address this issue. Pulmonary nodules less than 5 mm in patients with no previous history of malignancy require no follow up. Larger nodules require either interval follow up imaging or proceeding to investigations such as positron emission tomography and image or bronchoscopy guided biopsy.

Summary

Balancing the benefits of invasive investigations and associated anxiety against the risk of delayed treatment of an early lung cancer should be handled carefully through a multidisciplinary approach involving respiratory physicians, radiologists, surgeons, pathologists, and oncologists. The decision regarding appropriate management should be made following a detailed discussion with patients that considers level of fitness, comorbidities, quality of life, and personal preference.

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Authors and Affiliations

  1. Aintree University Hospital, Liverpool University Hospitals, NHS Foundation Trust, Lower Ln, Liverpool, L9 7AL, UK

    Mohammed Ahmed, Alex Jackson & Melanie Pritchard

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  1. Mohammed Ahmed
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Correspondence to Mohammed Ahmed.

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Ahmed, M., Jackson, A. & Pritchard, M. Pulmonary Nodules—an Epidemic—Work Up and Management, Specific, and Unique Issues in the Elderly. Curr Geri Rep 9, 107–112 (2020). https://doi.org/10.1007/s13670-020-00321-x

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