Solitary Pulmonary Nodule

Principles

  • Definition: single, well-defined, <3 cm, surrounded by nl lung, no LAN or pleural effusion
  • Often “incidentalomas,” esp with ↑ CT use, but may still be early, curable malignancy
Etiologies
Benign (70%) Malignant (30%)
Granuloma (80%): TB, histo, coccidio
Hamartoma (10%)
Bronchogenic cyst, AVM, pulm infarct
Echinococcosis, ascariasis, aspergilloma
GPA, rheumatoid nodule, sarcoidosis
Lipoma, fibroma, amyloidoma
Bronchogenic carcinoma (75%) periph: adeno (most common) & large cell central: squamous & small cell
Metastatic (20%): sarcoma, melanoma, breast, head & neck, colon, testicular, renal
Carcinoid, primary sarcoma

Initial evaluation