Respiratory Department- Aintree Hospital 

 

What is a Pulmonary Nodule?

  • A pulmonary nodule is an area of roundish shadowing usually one centimetre (approximately 1/3rd inch) or smaller in the lung.
  • It does not usually cause any symptoms but can be seen on a CT scan (Computed Tomography) and sometimes on a chest X-ray.

Why do Pulmonary Nodules occur?

  • Pulmonary nodules are very common. Approximately one in four (25%) of older people who smoke or who are ex-smokers have nodules on a CT scan.
  • People who have never smoked may also have nodules on a CT scan.
  • Most nodules are benign (non-cancerous) and maybe caused by scarring from previous lung infections.
  • They are very common in people who have had TB (Tuberculosis) and can occur in people who have other conditions such as Rheumatoid Arthritis.
  • In a small number of people the nodule could be a very early lung cancer or occasionally a secondary cancer that has spread from elsewhere in the body.

Diagnosing Pulmonary Nodules

  • Nodules are sometimes found on a chest X-ray but in most cases they are too small and are only seen when the person has a CT scan.
  • Pulmonary nodules are often found when the person is having a CT scan for another reason.
  • It is not always possible to know what the cause of a nodule is from the CT scan alone.

Because nodules are small a biopsy (a test performed to get a piece of the nodule) may not be possible. Instead, we monitor the size of the nodule by repeating the CT scan after a certain amount of time to see whether it grows.

  • Benign (non-cancerous) nodules grow very slowly or may not grow at all. On the other hand, malignant (cancerous) nodules will eventually grow, though this can happen slowly.
  • We can check if the nodule is changing by repeating a chest X-ray or CT scan over a period of months or years.
  • Because nodules can change very slowly there is no point in doing chest X-rays or CT scans any sooner than this.
  • If the nodule grows or changes in any way then your Chest Specialist (Doctor) may arrange for you to have further tests.

What happens next?

  • Your Chest Specialist may discuss your information at a team meeting with other specialist doctors and nurses.
  • A repeat chest X-ray or CT scan will be arranged. This is usually done three months after your first chest X-ray or CT scan, but it could be 6-12 months in some cases. Some nodules require no further CT scans.

It may be necessary to have a number of CT scans over a number of years.

This will depend on the results of your scans and other factors including:

  • if you smoke
  • your general health.

In some cases you may have another type of scan arranged called a PET-CT.

Your Chest Specialist will either write to you or see you in clinic to inform you of the result of your scan.

Alternatively the clinical support worker may contact you via telephone to inform you of results and future plans.

If you have had several scans and your nodule is not changing your doctor will decide when your nodule is stable.

At this point you will not need any more scans. They will either write to you or see you in clinic to let you know this.

If you have any of the following symptoms between your scans, then you should contact your GP who may wish to contact your Chest Specialist to see you sooner.

  • Pain in your chest.
  • Shortness of breath.
  • Repeated chest infections.
  • Coughing up blood.

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Further information

If you have any questions or worry about your condition please contact

Tel: 0151 529 2916

Text phone number: 18001 0151 529 2916

Author: Respiratory Department Aintree Hospital

Review date: May 2029

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