A pulmonary nodule is a small round or oval-shaped growth in the lung. It is sometimes also called a spot on the lung or a coin lesion. Pulmonary nodules are generally smaller than 3 centimeters in diameter. If the growth is larger than that, it is known as a pulmonary mass. A mass is more likely to represent a cancer than is a nodule.

There are two main types of pulmonary nodules: malignant (cancerous) and benign (noncancerous). Over 90% of pulmonary nodules that are smaller than 2 centimeters in diameter are benign.

Benign pulmonary nodules can have a wide variety of causes. Many are the result of inflammation in the lung as a result of an infection or disease producing inflammation in the body. The nodule may represent an active process or be the result of scar tissue formation related to prior inflammation. Benign developmental lesions may also appear as nodules.

Usually there are no symptoms associated with pulmonary nodules. If present, symptoms would be related to the condition that led to the nodule developing. If the nodule is from a lung cancer, the patient is often without symptoms but may have a new cough, or cough up blood.

Most of the time, a patient is unaware that he or she has a lung nodule until a chest X-ray or computed tomography scan (CT scan) of the lungs is performed.

When your lung nodule is considered highly suspicious based on its size, shape and appearance on chest x-ray or CT scan and your history of smoking and family history of lung cancer, it will need to be biopsied to determine if it is cancerous. The biopsy is a simple procedure of getting a sample from the pulmonary nodule for microscopic exam. It can be done surgically, bronchoscopically and by placing a needle thru the chest wall under radiographic guidance.

Once an evaluation is complete, the physicians at the Lung Center will make their treatment recommendation based on the diagnosis. For instance, if the cause of a nodule is:

1. Benign or indeterminate: In many cases, these tumors are simply observed and periodically re-evaluated with surveillance imaging (CT scans) over several years. During this time period, should the tumor change in either appearance or size, surgical management for removal may be recommended
2. Infection: Tissue diagnosis is critical in an infectious condition, in order to be able to accurately prescribe the appropriate antibiotics. In addition, we work hand in hand with Infectious Disease experts in the management and treatment of the entire range of bacterial, viral, and fungal infections
3. Inflammation: Inflammatory conditions of the lung are challenging and often difficult disease processes to diagnose and treat. Our Pulmonary Medicine specialists are leaders in the management of pulmonary fibrosis, interstitial pneumonitis, and chronic, obstructing, and obliterating pneumonias
4. Cancer: Pulmonary malignancies—especially when caught at an early stage— are often successfully treated to a cancer-free status with a multidisciplinary treatment protocol that may include surgery alone (including minimally invasive thoracoscopic and robotic techniques), radiation therapy and chemotherapy followed by surgery, or radiation and chemotherapy alone. Patients with pre-existing nodules who are diagnosed with lung cancer will receive the best in comprehensive medical care from a team of experts