Solitary Pulmonary Nodules

Question 1

Solitary pulmonary nodules are most commonly what?

Answer 1

35% are bronchiogenic carcinomas

Question 2

65 male w h/o smoking w 3mm pulm nodule, next step?

Answer 2

Follow up CT chest in 12 months if <= 4mm in a patient w smoking history

Question 3

65 male w 3 mm nodule but no smoking history, next step?

Answer 3

No imaging for <=4mm w/o smoking history or famhx of cancer

Question 4

65 male w no history of smoking but incidentally found to have 5mm pulmonary nodule, next step?

Answer 4

CT chest in 12 months for >4-6mm in no smoking or famhx of cancer

Question 5

65 male w famhx of lung cancer found incidentally to have 5mm pulm nodule, next step?

Answer 5

CT 6-12 months in person w smoking and famhx of cancer (>4-6mm)

Question 6

65 male found to have 7mm w no significant risk factors, next step?

Answer 6

CT chest 6-12 months, for >6-8mm in no smoking or famhx of lung cancer

Question 7

65 male w h/o smoking incidentally found to have 7mm nodule, next step?

Answer 7

CT 3-6 months for >6-8mm in person w risk factors

Question 8

For a pulmonary nodule >3cm next step?

Answer 8

Biopsy for tissue diagnosis if not suspect mets or surgical resection if find no evidence of mets disease

Question 9

If find a pulm nodule incidentally, what is the first step?

Answer 9

Compare to old imaging to determine stability

Question 10

If 65 male w h/o smoking with negative bronch w biopsy and percutaneous needle bx negative, next step?

Answer 10

Consider surgical resection because cannot reliably exclude malignant growth