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Lung Nodule

Cardio-thoracic SurgeryRespiratory Medicine

Lung nodules refer to localized shadows or masses in the lungs with a diameter of less than 3 cm. “Lung nodules” per se is not a disease name. They are often asymptomatic and are usually discovered incidentally during health check-ups or imaging studies. The management of lung nodules is highly individualized. If you discover that you have lung nodules, do not panic. It is advisable to seek assistance from a specialist for evaluation and management as soon as possible.

Symptoms

Lung nodules refer to localized shadows or masses in the lungs with a diameter of less than 3 cm. They are often asymptomatic and are usually discovered incidentally during health check-ups or imaging studies. However, in some instances, patients may experience the following symptoms:

  • Cough: Persistent dry cough or cough with a small amount of sputum.
  • Chest Pain: Localized discomfort or dull pain.
  • Hemoptysis (Coughing up Blood): Some malignant nodules can cause blood in the sputum.
  • Shortness of Breath: Occurs when the nodule is large or compresses the bronchi.

Classification

Based on the nature and imaging characteristics, lung nodules can be classified as follows:

1Classification by Nature

  1. Benign Nodules: Commonly caused by inflammation, infection, tuberculosis, or benign tumours (e.g., hamartoma).
  2. Malignant Nodules: May indicate lung cancer or other malignant lesions.

2Classification by Imaging Characteristics

  1. Solid Nodules: Nodules with uniform and higher internal density and complete obscure the underlying lung markings.
  2. Part-Solid Nodules: Nodules containing both solid components and ground-glass opacity.
  3. Pure Ground-Glass Nodules (GGN): Nodules that appear hazy and translucent.

3Classification by possibility of malignancy

  1. Low-risk Nodulerisk of malignancy <5%
  2. Intermediate-risk Nodulerisk of malignancy 5-65%
  3. High-risk Nodulerisk of malignancy >65%

Diagnosis

Imaging Examinations
  • Chest X-ray: A preliminary screening tool, but less sensitive for nodules with low density.
  • Chest CT: The standard tool for detecting nodules; it displays the location, size, density, and boundary characteristics of the nodule.
  • Positron Emission Tomography (PET-CT): Used to evaluate the nodule's metabolic activity, helping distinguish between benign and malignant lesions.

Pathological Examinations

  • Bronchoscopy: Suitable for nodules close to the bronchi, allowing tissue sampling for biopsy.
  • Percutaneous Needle Biopsy: Performed under CT guidance, using a fine needle to extract tissue samples.
  • Surgical Biopsy: Direct excision of the nodule through minimally invasive surgery. Suitable for nodules radiologically highly suspected to be malignant, or for nodules where non-surgical biopsy poses high risks and/or low yields. 
Follow-Up MonitoringRegular imaging surveillance (e.g. every 3-12 months) to observe any changes over time.

Treatments

The treatment plan depends on the size, nature, and pathological results of the nodule.

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HEAL Medical (Central)

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HEAL Medical (Tsim Sha Tsui)

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Sun & Public Holidays Closed
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Sun & Public Holidays Closed
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HEAL Fertility

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