Pulmonary (Lung) Nodules

Topic Overview

What are pulmonary (lung) nodules?

Pulmonary (lung) nodules are growths or "spots" in the lungs. You may have just one nodule (called a solitary pulmonary nodule) or more than one (called multiple nodules).

What causes lung nodules?

Lung nodules may be caused by:

• A lung cancer.
• A cancer that has spread (metastasized) to the lung from another part of the body.
• A growth that is not cancer.
• An infection, or a scar from an old infection.
• Conditions that cause inflammation, like sarcoidosis.
• Abnormal blood vessels that clump together, like an arteriovenous malformation.
• Being exposed to or breathing in harmful substances, like tobacco smoke or asbestos.

Often a cause is not found.

What are the symptoms of lung nodules?

A lung nodule might not cause any symptoms. But you may have symptoms from whatever caused the nodule, like symptoms of an infection.

How are lung nodules diagnosed?

Your doctor may have found one or more nodules on your lung when you were having a chest X-ray or CT scan.

To diagnose the cause of nodules, your doctor will:

• Ask about your symptoms, do a physical exam, and review your medical history.
• Look at your X-rays or CT scan to find out the size, shape, location, and number of nodules you have.
• Order other tests, if needed, such as:
  • Blood tests to find out if inflammation or an infection might be the cause.
  • A PET scan to help find out if the nodule might be cancer.
  • A biopsy (a tissue sample) to find out if the nodule might be cancer or another problem.

What increases the risk that a lung nodule is cancer?

Your doctor will look at several things to see how likely it is that a nodule is cancer. He or she will look at:

• Whether you smoke or have smoked in the past.
• Your age and your family's medical history.
• Whether you have been exposed to or breathed in harmful materials, like tobacco smoke, asbestos, or coal dust.
• The size and shape of the nodule.
• Whether the nodule has changed in size. Your doctor may look at any past chest X-rays or CT scans and compare them. Or you may have a series of CT scans to see if the nodule grows over time.

How are lung nodules treated?

If the cause of the nodule is clear (for example, if it's caused by an infection or inflammation), you may need medicine to treat that problem.

If the cause is not clear, you may need more tests or treatment, depending on the risk that the nodule may be cancer.

• If the risk of cancer is small, your doctor may just want to watch to see if the nodule changes over time. Or he or she may want you to have regular follow-up appointments and tests. For example, you may have a CT scan every 3 to 6 months to see if the nodule is growing.
• If there is a higher risk of cancer, you may need more tests like a PET scan or biopsy (a tissue sample). If the nodule turns out to be cancer, you may need surgery to remove the cancer. Or you may need some type of cancer treatment.