Pulmonary Nodule

A pulmonary nodule is a small area of roundish shadowing or “spot” in your lung which measures 3cm or less. A person may have several nodules. These nodules can be thought of as ‘freckles’ or ‘skin tags’ in the lung tissue.

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You have recently had a CT scan which has identified a pulmonary nodule.

What is a pulmonary nodule?

A pulmonary nodule is a small area of roundish shadowing or “spot” in your lung which measures 3cm or less. A person may have several nodules. These nodules can be thought of as ‘freckles’ or ‘skin tags’ in the lung tissue.

Pulmonary nodules do not usually cause any symptoms and are often too small to investigate.

Pulmonary nodules can be seen on a CT scan and sometimes on a chest x-ray and are often found when having a scan for other reasons or conditions. A CT scan is a scan of the inside of the body and produces more detailed images than an x-ray.

What causes pulmonary nodules?

Pulmonary nodules are very common.

Approximately 1 in 4 older people who smoke or who have smoked in the past have pulmonary nodules. People who have never smoked may also have pulmonary nodules.

Most pulmonary nodules are benign (non-cancerous) and may have been caused by scarring from previous lung infections. People may not be aware that they have had an infection in their lung previously.

Other conditions such as rheumatoid arthritis may cause pulmonary nodules.

In a small number of people the nodule could be an early lung cancer or a secondary cancer that has spread from elsewhere in the body.

Diagnosing the cause of a pulmonary nodule

It is not easy to know the cause of a nodule from one CT scan and because they are so small. Completing a biopsy (taking a piece of the nodule and examining it) is usually impossible or potentially risky.

We usually keep an eye on the nodule by repeating the CT scan after a certain amount of time to see if it grows.

Most people with a nodule need multiple scans over 1 to 4 years.

Cancerous nodules will eventually grow although this can happen slowly. Benign (non- cancerous) nodules may also grow very slowly, although many do not grow at all. If the nodule grows or changes the nodule team may arrange for you to have further tests.

What happens next?

A repeat CT scan will be arranged usually at 3 or 12 months from the initial scan.

If your nodule stays the same or shrinks we may be able to discharge you.

If your nodule grows or changes you may need further tests which may include a different type of scan called a PET scan. A PET scan is like a CT scan but uses a different type of mild radioactive liquid to show up cells that are more active than normal.

The decision for further investigation or type of investigation will be based on a number of factors including the size and type of the nodule, your age, whether you have any history of any cancer, a history of smoking, your general health and medical problems and your own wishes about further investigations or potential treatments.

How will I get my results?

You will be informed of your results of your scans either by letter, a telephone consultation or at an outpatient appointment.

Your scan may need to be discussed in a specialist lung team meeting.

Please note that following your CT scan, we cannot give you any results until it has been reported by a radiologist. It can take up to 6 weeks for you to receive the results of your CT scan.

Your GP will also be kept informed about your investigations and progress.

Contact details

If you have any queries, please contact the respiratory secretaries on the following telephone numbers who will pass your details to one of the nodule team.

Lincoln County Hospital respiratory secretaries:

01522 573226 / 573417 / 707297

Pilgrim Hospital, Boston respiratory secretaries:

01205 446406 / 446631