The pulmonary nodule diagnosis and its causes

Written by: Dr. Josep Morera Prat
Edited by: Top Doctors®


What is a pulmonary nodule?

A pulmonary nodule is a shadow or a rounded or elliptical opacity, in 2 dimensions we would see it as circumferential, in 3 dimensions we could imagine it as elliptical. And that we usually detect it either by a chest radiography or by a scanner. Nowadays with the scanners we detect pulmonary nodules of very small dimensions, between 3 millimeters and 20 millimeters for example, that previously we could not detect by chest x-ray. The detection of a pulmonary nodule always generates concern in the person who is detected by the fact that at some point it is interpreted as a synonym of non-benign disease. Not so, fortunately most of the times it is detected by chance and not by symptoms the cause is benign or harmless or innocent, but it is also true that in certain contexts it never has to go unnoticed by the doctor or the patient. of a pulmonary nodule.


The scanners detect pulmonary nodules of very small dimensions


What are the causes of the pulmonary nodule?

The list of causes of a pulmonary nodule is very long, we could say that there are more than 100 causes of pulmonary nodule, but in the end what interests us the doctor and, especially to the patient is whether it is a benign or non-benign lesion. The causes of benign injury are usually, or are not diagnosed or are banal or infectious, and may be current infections or may be old infections. And if they are tumor, in lung although there are benign tumors, such as for example, amartomas or calcinoid tumors, etc., always, in spite of everything, if they are tumors we have to think that they are not benign tumors.


How can the pulmonary nodule be diagnosed?

Normally the same radiological characteristics of the nodule can guide us, if they have fat it could be an amartoma, if they have calcification it could be an old lesion, but often we can not make a diagnosis in the first visit and then the criterion will be to know if we have to move on to more complicated, more invasive tests, or if we can simply wait. If the dimensions are small it is possible that all we do is wait, 3, 6, 12 months and the growth will tell us if it is a benign or non-benign lesion. If the injury is already at the beginning, for example, more than 10 millimeters or around 10 millimeters, surely we will need to do more immediate tests that can be either Tac-Pet, brochoscopy, direct puncture or even if our suspicion is very high in that it can be a lesion not benign then, it is possible that we get to indicate the surgical intervention and the analysis of the surgical piece by pathological anatomy is the one that will give us the diagnosis.


What risk factors are there for lung nodules to treat cancer?

The risk factors are very well defined, the main one of all is tobacco and it is accumulated tobacco, that is, the number of packages and the number of accumulated years of tobacco. If emphysema is present, which is also detected by Tac, this is also a risk factor. And if there is bronchial obstruction, this is also a risk factor. It would be necessary to say that a person of 55-60 years who is a smoker until that moment, who has emphysema and who has obstruction, the probability of developing a cancer during the next 10 years is 10%, that is, these patients followed , one in 10 at 10 years will have developed a cancer.

*Translated with Google translator. We apologize for any imperfection

By Dr. Josep Morera Prat
Pulmonary Disease

Dr. Morera Prat is a leader in Pneumology and one of the foremost experts on COPD, asthma, lung cancer, sleep apnea syndrome and sarcoidosis. He has held senior positions in various prestigious institutions and scientific societies. He is currently director of the service of Pneumology Hospital Cima and Teknon Clinic. He was a member of the National Commission for the specialty of Pulmonology of the Ministry of Health and Ministry of Education and Science. Recognized with several awards, he has performed more than 200 papers and participated in at least 50 books. His long and full career and you have become a specialty eminence.

*Translated with Google translator. We apologize for any imperfection

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