PILL series. The solitary pulmonary nodule.
The solitary pulmonary nodule on chest X-ray (CXR) is a common problem in pulmonary medicine. Its presence raises the question of lung cancer. As five-year survival after resection of a solitary bronchogenic carcinoma can be as high as 80%, prompt evaluation is crucial. This should begin with a cancer risk assessment based on clinical and radiographic factors. The risk and benefits of surgery should next be assessed, and together with the patient's preferences, a management plan can be decided upon. Surgery is recommended for patients at high risk of malignancy with a low surgical risk, while careful observation is adopted for patients at low risk of malignancy coupled with a high surgical risk. Further diagnostic tests may be warranted to aid in this decision process. Although CXR is not useful for lung cancer screening, low-dose computed tomography imaging is increasingly recommended for individuals at high risk for lung cancer.
Department of Respiratory & Critical Care Medicine, Changi General Hospital, Singapore.
Jansen Meng Kwang
JM
Koh
Gerald Jit Shen
GJ
Tan
Choon How
CH
How
D000368:Aged; D003952:Diagnostic Imaging / Q000379:methods; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis; D008175:Lung Neoplasms / Q000175:diagnosis; D008875:Middle Aged; D015272:Pulmonary Medicine / Q000379:methods*; D011859:Radiography / Q000379:methods; D013902:Radiography, Thoracic / Q000379:methods; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis*