Know the workup of a solitary pulmonary nodule
Explanation:
A solitary pulmonary nodule consists of a solid nodule 1-6 cm in diameter that is surrounded by normal aerated lung tissue.
Once this picture is found, one works it up according to the probability of it being malignant.
Some clinical features and some radiological features are useful pointers.
The best is to compare it with another X-ray of the chest that is more than 2 years old (if available). If no change has occurred, it is most likely benign.
Features that point towards a malignant potential are:
In all the above 5 scenarios, a histologic diagnosis is important. if none of the above exist then one should re X-ray it in 6 months
If the lesion is in the medial 2/3 of the lung fields then a bronchoscopic biopsy is best. If in the peripheral 1/3 then a CT guided biopsy is appropriate.
Once a malignancy is established then one has to work - up a non small cell carcinoma. A small cell Ca is considered non-operable and is treated with chemotherapy.