Pulmonary Nodules: Spots on the Lungs Explained Simply

A pulmonary nodule, also known as a lung nodule or a "spot on the lung," is a small growth or abnormal area of tissue that appears in the lung. They are quite common, and in the vast majority of cases, they are not cancerous. Think of it like a mole on your skin – most moles are harmless.  

Key Points:

• Small and Roundish: Nodules are usually small, often round or oval-shaped, and are typically less than 3 centimeters (a little over an inch) in diameter. Larger spots are more likely to have a higher risk of being cancerous.  

• Found on Imaging: Pulmonary nodules are usually discovered when someone has a chest X-ray or CT scan for another reason, such as investigating a cough or chest pain, or as part of a lung cancer screening. Often, the person with a nodule doesn't even know it's there.  

• Most are Benign: The vast majority of pulmonary nodules (over 90%) are non-cancerous (benign). They can be caused by old infections, scars, inflammation, or other non-cancerous conditions.  

• Sometimes Cancerous: However, a small percentage of pulmonary nodules can be cancerous (malignant). The risk of cancer is higher in people who smoke or have a history of cancer, and in nodules that have certain characteristics (larger size, irregular shape).  

• Not a Disease Itself: A pulmonary nodule is not a disease itself, but rather a finding or sign that something is present in the lung. It is the underlying cause of the nodule that is important.

What happens if a nodule is found?

If a pulmonary nodule is found on an imaging test, the doctor will assess the risk of it being cancerous. Several factors are considered:  

1. Size and appearance: Larger nodules and those with irregular borders are more concerning.  

2. Patient's history: Smoking, age, and any prior history of cancer are taken into account.  

3. Changes over time: If previous scans are available, the doctor will look to see if the nodule has grown or changed in appearance over time. Growth is more suspicious for cancer.

Based on this assessment, the doctor might recommend:

• Monitoring: For small nodules with a low risk of cancer, the doctor might recommend regular CT scans over a period of time (usually 1-2 years) to see if it changes.

• Further testing: If the nodule has a higher risk of being cancerous, the doctor might recommend further imaging tests (like a PET scan) or a biopsy to get a sample of the nodule and test it. A biopsy can be done with a needle or during a bronchoscopy (where a thin tube with a camera is inserted into the lungs).  

• Surgical removal: In some cases, if the nodule is highly suspicious for cancer, the doctor might recommend surgical removal.  

In summary: Finding a pulmonary nodule can be worrying, but it is important to remember that most are not cancer. Doctors carefully evaluate each case to determine the best course of action. If you have any concerns or questions about a pulmonary nodule found on your scan, it is important to discuss them with your doctor.