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A lung nodule or pulmonary nodule is a relatively small focal density in the lung. A solitary pulmonary nodule (SPN) or coin lesion, [1] is a mass in the lung smaller than three centimeters in diameter. A pulmonary micronodule has a diameter of less than three millimetres. [2] There may also be multiple nodules.
The criteria for diagnosing pulmonary adenocarcinoma have changed considerably over time. [10] [11] The 2011 IASLC/ATS recommendations, adopted in the 2015 WHO guidelines, use the following criteria for adenocarcinoma in situ: [12] tumor ≤3 cm; solitary tumor; pure "lepidic" growth* [13] No stromal, vascular, or pleural invasion
Multiple nodules Likely ultrasonography Solitary nodule in person younger than 35 years old Likely ultrasonography if at least 1 cm large in adults, or for any size in children. None needed if less than 1 cm in adults; Solitary nodule in person at least 35 years old Likely ultrasonography if at least 1.5 cm large; None needed if less than 1.5 cm
They occur most often as solitary, infratentorial lesions in young children. [3] In contrast, lesions are most often supratentorial in adults. [3] Pulmonary tuberculomas are among the most common benign nodules, with 5%-24% of all resected nodules being of tuberculous origin. [21]
If the measurable disease is restricted to a solitary lesion, its neoplastic nature should be confirmed by cytology/histology. Measurable lesions – lesions that can be accurately measured in at least one dimension with longest diameter ≥20 mm using conventional techniques or ≥10 mm by spiral CT scan.
Pulmonary function: increased residual volume, increased total lung capacity, fixed obstruction, low diffusing capacity of the lung for carbon monoxide that corrects with alveolar volume; High-resolution CT scan: diffuse pulmonary nodules 4–10 mm, greater than 20 nodules, mosaic attenuation or air trapping in greater than 50% of the lung
Consideration of surgery is recommended for Stage 1 limited-stage small cell lung cancer patient with a solitary nodule, no hilar or mediastinal involvement, absence of distant metastases, and no contraindications to surgery classified by the TNM staging system. [18] Surgery is normally followed by chemotherapy.
3. Nodule with poorly defined margins - Round density within the lung parenchyma, also called a tuberculoma. Nodules included in this category are those with margins that are indistinct or poorly defined (tree-in-bud sign [3]). The surrounding haziness can be either subtle or readily apparent and suggests coexisting airspace consolidation.