Solitary pulmonary nodule

Question 1

Definition of solitary pulmonary nodule

Answer 1

• Single lesion in the lung < 3 cm
• Completely surrounded by normal lung parenchyma

Question 2

Definition of pulmonary mass

Answer 2

• Lung lesion >3 cm

(Cancer until proven otherwise)

Question 3

Differentials for solitary pulmonary nodule (categories + example of each)

Answer 3

CABIN

• Congenital (AVM)
• Autoimmune (Sarcoid)
• Benign (Hamartoma)
• Infectious (Granuloma, abscess)
• Neoplastic (bronchogenic, mets)

Question 4

Thin wall likely/unlikely cancer?

Answer 4

Unlikely cancer

Question 5

Calcification likely/unlikely cancer?

Answer 5

Likely cancer

Question 6

Investigations for a solitary pulmonary nodule

Answer 6

• Bloods: FBE, coags, UEC, ABGs
• Special lab tests: tuberculin skin test, sputum culture
• Pulmonary function tests
• Imaging: CXR, CT, PET scan
• Invasive: Biopsy

Question 7

Management for solitary pulmonary nodule

Answer 7

• Serial radiographs (young non-smoker)

OR

• Surgical resection