You may have one nodule on the lung or several nodules. Nodules may develop in one lung or both. Most lung nodules are benign (not cancerous). Rarely, pulmonary nodules are a sign of lung cancer.
Abstract. Multiple synchronous lung nodules are frequently encountered on computed tomography (CT) scanning of the chest and are most commonly either non-neoplastic or metastases from a known primary malignancy. The finding may initiate a search for primary malignancy elsewhere in the body.
Most lung nodules are benign, or non-cancerous. In fact, only 3 or 4 out of 100 lung nodules end up being cancerous, or less than five percent. But, lung nodules should always be further evaluated for cancer, even if they're small.
Nodules between 6 mm and 10 mm need to be carefully assessed. Nodules greater than 10 mm in diameter should be biopsied or removed due to the 80 percent probability that they are malignant. Nodules greater than 3 cm are referred to as lung masses.
Multiple pulmonary nodules and masses may result from infection (e.g., tuberculosis, fungal infection, septic embolism), neoplasms (e.g., metastases, lymphoma), inflammatory processes (Wegener granulomatosis, rheumatoid nodules), or trauma (multiple pulmonary hematomas) or may be congenital (arteriovenous malformations ...
However, your doctor may suspect a lung nodule is cancerous if it grows quickly or has ridged edges. Even if your doctor believes the nodule is benign or noncancerous, he or she may order follow-up chest scans for some time to monitor the nodule and identify any changes in size, shape or appearance.
The Mechanics of Pulmonary Nodules
There is very little growth or change, if there's any at all. Cancerous pulmonary nodules, however, are known to grow relatively quickly—usually doubling in size every four months but sometimes as fast as every 25 days.
Providers may be more worried about larger lung nodules and those that grow over time. If your nodule is large or is growing, you might need more tests to see if it's cancer. This might include imaging tests, such as CT and positron emission tomography (PET) scans. Another test might be a procedure called a biopsy.
Lung nodules are quite common and are found on one in 500 chest X-rays and one in 100 CT scans of the chest. Lung nodules are being recognized more frequently with the wider application of CT screening for lung cancer. Roughly half of people who smoke over the age of 50 will have nodules on a CT scan of their chest.
Compared to their cancerous counterparts, benign lung nodules will not spread to multiple parts of the body (metastasis) and are typically not life-threatening. Sometimes, these nodules may be inflammatory in nature and can shrink or spontaneously disappear by the time of your next scan.
Multiple nodules in the lungs or multiple pulmonary nodules (MPN) refer to two or more lesions in the lungs. Lung cancer such as bronchoalveolar carcinoma and lymphoma are the most common causes of MPN. These infections result in inflammation, which further forms a granuloma.
The treatment for multiple lung nodules depends on the cause. Benign nodules can often be left alone. Nodules related to an infection can be treated with the appropriate antibiotic, antifungal, or antiparasitic drugs. If metastatic cancer is diagnosed, treatment is based on where the tumor is.
The most common causes of lung nodules are inflamed tissue due to an infection or inflammation (called granulomas) or benign lung tumors (such as hamartomas). Less common, malignant lung nodules are typically caused by lung cancer or other cancers that have spread to the lungs (metastatic cancer).
Location. Location of nodules in the lung is another important predictor as nodules on the upper lobes are more likely to be malignant. Although etiology of this predilection is unclear, higher concentration of inhaled carcinogens could be a possibility.
Some nodules will be followed with a repeat CT scan in 6-12 months for a few years to make sure it does not change. If the lung nodule biopsy shows an infection, you might be sent to a specialist called an infectious disease doctor, for further testing.
Small lesions are common and usually aren't worrisome. About 95% of lung nodules found on first-time CT scans of current and former smokers who are between age 50 and 75 are not cancerous. 1 However, it's essential to follow through on getting a diagnosis, even if you've never smoked.
Biopsies are usually not recommended when nodules are small because it is very difficult to biopsy them safely. Doing a biopsy when a nodule is small can cause harm such as trouble breathing, bleeding, or infection. Biopsies are often done for nodules that are 9 mm or larger.
In the vast majority of cases, lung nodules turn out to be small benign scars, indicating the site of a previous small area of infection. These nodules may be permanent or may even spontaneously disappear by the time of the next scan. Most are of absolutely no consequence.
The short answer is no. A CT scan usually isn't enough to tell whether a lung nodule is a benign tumor or a cancerous lump. A biopsy is the only way to confirm a lung cancer diagnosis. But the nodule's characteristics as seen on a CT scan may offer clues.
If lung nodules are large or malignant, they may cause symptoms, including: Chronic cough. Blood-tinged sputum. Shortness of breath.
4.3.
Regularly shaped pulmonary nodules were slightly more frequent in never smokers (93.4%) compared to current smokers (90.2%). The same was observed for pulmonary nodules with smooth margin (never smokers (93.8%) compared to current smokers (90.4%)).
Treatment for lung nodules may range from a “watchful waiting” approach for benign nodules, to surgery, chemotherapy and radiation therapy for malignant nodules. If the nodule is benign, your physician will monitor the nodule periodically with CT scans, to determine if any changes in size or shape have occurred.
Most cancers grow fairly slowly, and it takes several months for them to get bigger. So even if the nodule is lung cancer, it will likely still be small in a few months. Even if the nodule is lung cancer that is growing, there is a very good chance that surgery or radiation will cure you.
The smaller the nodule, the more likely it is to be benign. Also, benign nodules grow very slowly, if at all, while cancerous nodules on average can double in size every four months or less. Nodule content, shape and color: Another way to tell a benign lung nodule from a malignant one is to test its calcium content.