title: [Pulmonary nodules in underlying malignant diseases--not necessarily metastases of the primary tumour].
abstract: BACKGROUND
  In this study the histological examination of pulmonary nodules and a comparison of the number of pre-, intra- and post-operative lung metastases in patients with a previous history of malignant disease were assessed.
  
  
  METHODS
  Between 1998 and 2003 we operated on 276 patients with suspected lung metastases. The histology of the primary tumour, the number of preoperatively diagnosed nodules, the number of lesions removed during surgery and the number of histologically confirmed metastases of 276 patients are presented.
  
  
  RESULTS
  In 276 patients a resection was performed. 161 of the patients were men (58.1%). The median age was 62 years (range: 21-86 years). In 110 cases a left-sided thoracotomy was performed (39.8%), in another 110 cases a right-sided thoracotomy was performed and in 56 cases we performed a bilateral thoracotomy (20.4%). In 15.2% the histology of the resected nodules was benign. In 8.6% of the cases the histological examination showed a primary lung cancer in stage I, in 74.4% of the cases the histology confirmed a metastasis of the primary cancer.
  
  
  CONCLUSIONS
  Solitary pulmonary nodules in patients with a previous history of malignant disease should always be resected for histological examination. Multiple pulmonary nodules should be histologically reappraised if there is any doubt about the entity.
authors.affiliation: Lungenklinik, Kliniken der Stadt Köln gGmbH, Köln. beckersf@kliniken-koeln.de
authors.forename: F
authors.initials: F
authors.lastname: Beckers
authors.forename: C
authors.initials: C
authors.lastname: Ludwig
authors.forename: J
authors.initials: J
authors.lastname: Cerinza
authors.forename: E
authors.initials: E
authors.lastname: Stoelben
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000453:epidemiology* / Q000473:pathology*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D003074:Solitary Pulmonary Nodule / Q000453:epidemiology / Q000473:pathology / Q000556:secondary; D055815:Young Adult