Respiratory Medicine - Royal Liverpool Hospital
The term ‘lung nodule’ is used when describing a small area that has been seen on a chest X-ray or computed tomography (CT) image of the lung. The area is often between 5mm and 30mm in size and is slightly denser in appearance compared to the lung tissue around it.
Lung Nodules are most commonly incidental (found because the scan has been done for another reason) and do not cause any symptoms or affect the function of the lungs themselves. They can be solitary (one) or multiple. They are seen in approximately 25% of all CT scans of the lungs and in approximately 98% of people, they are of no clinical significance.
There are different appearances to lung nodules, some are called solid, some are sub-solid and some are ground glass.
Solid and sub-solid nodules require up to two years of follow up and ground glass nodules require up to four years of follow up with repeat CT scans at defined intervals.
Nodules may represent an area of scarring of the lung from a previous infection. They may also represent an area of active infection or may be a lymph node (or gland) within the lung. In a small number of cases, they may represent a very early cancer and so it is important that they are monitored.
Why am I being told about lung nodules?
You have had a CT scan which has shown one or more lung nodules.
Because a nodule has been identified, you have been referred to the Nodule Surveillance Team and we have placed you into the ‘nodule surveillance programme’ according to British Thoracic Society Guidelines.
The British Thoracic Society (BTS) have analysed a lot of data, to understand the follow up required for the different types of nodules. We follow the guidance they suggest, making sure we are following evidence-based practice.
We also use scoring systems that can help us to predict how likely the nodule is to be a cancer. This includes assessing growth rate, number, position and appearance of the nodule(s).
How will I be kept informed about my follow up CT scans and results?
The nodule team will review your original X-ray or CT scan and make decisions about when to arrange the next scan. It is extremely important that you attend for the scan so that we can check that the nodule has not changed.
The nodule team will contact you by way of letter to let you know the result and when the next scan is required as per BTS guidance.
Why am I being offered a letter for the results and not a clinic appointment?
Most nodules that are identified on routine CT scanning are of no clinical significance. Many do not grow and do not cause any symptoms. Because of this the main form of correspondence is by letter to let you know the results of your CT scan and when your next one will be due.
What if the nodule changes and gets bigger?
If a nodule changes in its size or appearance the nodule team will contact you and explain the next steps. This may involve another scan or test. A member of the nodule team will contact you, so that you can ask questions and to make sure that you understand why extra tests or scans are being requested and what this might mean for your ongoing surveillance or care.
Feedback
Your feedback is important to us and helps us influence care in the future.
Following your discharge from hospital or attendance at your outpatient appointment or you will receive a text asking if you would recommend our service to others. Please take the time to text back, you will not be charged for the text and can opt out at any point. Your co-operation is greatly appreciated.
Further Information
If you would like to talk to a member of the nodule team because you have questions or want more information, please do not hesitate to contact the team.
The Lung Nodule Team includes two Consultant Chest Physicians, a Specialist Nurse and two Respiratory Secretaries.
We can be contacted on:
0151 706 2289 or 0151 706 4364
Textphone Number:
08001 0151 706 2289 or 08001 0151 706 4364
If you are a current smoker, we would encourage you to consider stopping smoking with treatment and support. This is available through Smoke Free Liverpool
TXT QUIT 66777
Tel: 0151 374 2535
Tel: 0800 061 4212
The British Thoracic Society Brit-thoracic.org.uk
Author: Respiratory Medicine Department
Review date: March 2027
PI 3064 V1