title: Natural history of incidental pulmonary nodules in children.
abstract: BACKGROUND
  As there are no evidence based guidelines for the diagnosis and/or management of pulmonary nodules in children, there is an over reliance on the adult based algorithms when dealing with pulmonary nodules in children. We present our experience of pediatric patients evaluated for incidentally found pulmonary nodules.
  
  
  METHODS
  Retrospective chart review of patients diagnosed with a pulmonary nodule and evaluated at Goryeb Children's Hospital between January 2000 and December 2012.
  
  
  METHODS
  change in the size of the pulmonary nodule between the initial and follow-up imaging.
  
  
  RESULTS
  Thirty six patients with pulmonary nodule (21 male/15 female; Median [range] age 15 [5-20] years.) were included in the study. Chest CT was obtained for respiratory symptoms and/or abnormal chest radiograph in 19 (52%). Nine pulmonary nodules (25%) were identified on abdominal CT obtained for abdominal symptoms. A total of 46 nodules were identified in 36 patients. Nine of the pulmonary nodules (9 patients) were ≤4 mm in size, 37 of the pulmonary nodules (27 patients) were >4 mm in size. Twenty-two of the 27 (81%) patients with nodule size >4 mm had follow-up CT: 14 nodules (54%) remained unchanged in size, 5 nodules (19%) decreased in size, and 7 nodules (27%) were not detected.
  
  
  CONCLUSIONS
  Our review of 36 patients with pulmonary nodules shows no obvious growth of the nodules over the study period, suggesting low risk of malignancy. Routine follow-up chest computer tomography using ACCP/Fleischner Society guidelines may not apply in children without known malignancy.
authors.affiliation: Respiratory Center for Children, Goryeb Children's Hospital, Atlantic Health System, Morristown, New Jersey.
authors.forename: Dagnachew
authors.initials: D
authors.lastname: Assefa
authors.forename: Arthur B
authors.initials: AB
authors.lastname: Atlas
mesh_terms: D000293:Adolescent; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D019468:Disease Management; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008297:Male; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D057832:Watchful Waiting; D055815:Young Adult
keywords: Pulmonary nodule; children; fleischner society guideline