title: Guideline on management of solitary pulmonary nodule.
abstract: The aim of the proposed recommendations is be a tool to facilitate decision-making in patients with a solitary pulmonary nodule (SPN). For an optimal decision, accessibility to the different diagnostics techniques and patient preferences need to be incorporated. The first assessment, which includes a chest computed tomography scan, separates a group of patients with extrapulmonary neoplasm or a high surgical risk who require individualized management. Another two groups of patients are patients with SPN up to 8mm and those who have a subsolid SPN, for which specific recommendations are established. SPN larger than 8mm are classified according to their probability of malignancy into low (less than 5%), where observation is recommended, high (higher than 65%), which are managed with a presumptive diagnosis of localized stage carcinoma, and intermediate, where positron emission tomography-computed tomography has high yield for reclassifying them into high or low probability. In cases of intermediate or high probability of malignancy, transbronchial needle aspiration or biopsy of the nodule may be an option. Radiologic observation with low radiation computed tomography without contrast is recommended in SPN with low probability of malignancy, and resection with videothoracoscopy in undiagnosed cases with intermediate or high probability of malignancy.
authors.affiliation: Servico de Neumología, Hospital Universitario 12 de Octubre, Madrid, España, CIBERES. Electronic address: carlosjose.alvarez@salud.madrid.org.
authors.forename: Carlos J
authors.initials: CJ
authors.lastname: Álvarez Martínez
authors.affiliation: Cardiothoracic Imaging Division, University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Canadá; Servicio de Radiología, Clínica Universidad de Navarra, Pamplona, España.
authors.forename: Gorka
authors.initials: G
authors.lastname: Bastarrika Alemañ
authors.affiliation: Servicio de Neumología, Hospital Universitario Valladolid, Valladolid, España.
authors.forename: Carlos
authors.initials: C
authors.lastname: Disdier Vicente
authors.affiliation: Servicio de Neumología, Hospital de Vigo, Vigo, España.
authors.forename: Alberto
authors.initials: A
authors.lastname: Fernández Villar
authors.affiliation: Servicio de Neumología, Complejo Asistencial de Ávila, Hospital de Ávila, Ávila, España.
authors.forename: Jesús R
authors.initials: JR
authors.lastname: Hernández Hernández
authors.affiliation: Servicio de Medicina Nuclear, Hospital Universitario Quirón, Madrid, España.
authors.forename: Antonio
authors.initials: A
authors.lastname: Maldonado Suárez
authors.affiliation: Servicio de Cirugía Torácica, Hospital Virgen Rocío, Sevilla, España.
authors.forename: Nicolás
authors.initials: N
authors.lastname: Moreno Mata
authors.affiliation: Servicio de Neumología, Hospital Universitario de Bellvitge, Barcelona, España.
authors.forename: Antoni
authors.initials: A
authors.lastname: Rosell Gratacós
mesh_terms: D000465:Algorithms; D006801:Humans; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis* / Q000628:therapy*
keywords: Cáncer de pulmón; Lung cancer; Nódulo pulmonar solitario; Nódulo subcentimétrico; Nódulo subsólido; Solitary pulmonary nodule; Subcentimeter nodule; Subsolid nodule