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Evaluation of solitary pulmonary nodule detected during computed tomography examination.

Choromańska A, Macura KJ - Pol J Radiol (2012)

Bottom Line: The solitary pulmonary nodule (SPN) has always been a diagnostic challenge for the radiologists.Currently, with increased utilization of computed tomography (CT) greater number of nodules is being discovered, with numerous indeterminate lesions, which frequently cannot be immediately classified into benign or malignant category.In this article we review the imaging features of benign and malignant round opacities; we demonstrate currently used standards and also more advanced techniques that are helpful in evaluating SPNs such as contrast-enhanced CT, PET/CT imaging and also pathologic sampling with biopsy or surgical resection.We also summarize the methods of evaluating and managing SPNs based on the latest guidelines from the Fleischner Society and American College of Chest Physicians.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Military Institute of Medicine, Warsaw, Poland.

ABSTRACT
The solitary pulmonary nodule (SPN) has always been a diagnostic challenge for the radiologists. Currently, with increased utilization of computed tomography (CT) greater number of nodules is being discovered, with numerous indeterminate lesions, which frequently cannot be immediately classified into benign or malignant category.In this article we review the imaging features of benign and malignant round opacities; we demonstrate currently used standards and also more advanced techniques that are helpful in evaluating SPNs such as contrast-enhanced CT, PET/CT imaging and also pathologic sampling with biopsy or surgical resection.We also summarize the methods of evaluating and managing SPNs based on the latest guidelines from the Fleischner Society and American College of Chest Physicians.

No MeSH data available.


Related in: MedlinePlus

Metastatic cavitary nodule due to squamous cell carcinoma.
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Related In: Results  -  Collection


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f12-poljradiol-77-2-22: Metastatic cavitary nodule due to squamous cell carcinoma.

Mentions: Some pulmonary nodules can demonstrate cavitary appearance. Cavitations can be present in infectious or inflammatory lesions (Figure 11) as well as in primary and metastatic malignancies; up to 15% of primary lung cancers cavitate, mostly of squamous cell pathology (Figures 12, 13) [11]. Although the presence of cavitation itself is not a strong differentiating factor, the appearance and thickness of a cavity wall can play useful role in diagnosis. Benign cavities tend to have smooth, thin walls, usually less than 4 mm at its broadest point, whereas nodules containing cavities with irregular, thick walls (exceeding 16 mm) have been found to be malignant in up to 95% of cases [20,21]. Overall, the thickness of a cavity wall within a nodule might add some value in assessing a lesion but cannot reliably differentiate between benign and malignant etiology. Woodring et al. have shown that cavitary nodules with wall thickness between 5–15 mm were found to be benign (51%) and malignant (49%) signifying that in this range there is a “gray-zone”[11,20].


Evaluation of solitary pulmonary nodule detected during computed tomography examination.

Choromańska A, Macura KJ - Pol J Radiol (2012)

Metastatic cavitary nodule due to squamous cell carcinoma.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3403798&req=5

f12-poljradiol-77-2-22: Metastatic cavitary nodule due to squamous cell carcinoma.
Mentions: Some pulmonary nodules can demonstrate cavitary appearance. Cavitations can be present in infectious or inflammatory lesions (Figure 11) as well as in primary and metastatic malignancies; up to 15% of primary lung cancers cavitate, mostly of squamous cell pathology (Figures 12, 13) [11]. Although the presence of cavitation itself is not a strong differentiating factor, the appearance and thickness of a cavity wall can play useful role in diagnosis. Benign cavities tend to have smooth, thin walls, usually less than 4 mm at its broadest point, whereas nodules containing cavities with irregular, thick walls (exceeding 16 mm) have been found to be malignant in up to 95% of cases [20,21]. Overall, the thickness of a cavity wall within a nodule might add some value in assessing a lesion but cannot reliably differentiate between benign and malignant etiology. Woodring et al. have shown that cavitary nodules with wall thickness between 5–15 mm were found to be benign (51%) and malignant (49%) signifying that in this range there is a “gray-zone”[11,20].

Bottom Line: The solitary pulmonary nodule (SPN) has always been a diagnostic challenge for the radiologists.Currently, with increased utilization of computed tomography (CT) greater number of nodules is being discovered, with numerous indeterminate lesions, which frequently cannot be immediately classified into benign or malignant category.In this article we review the imaging features of benign and malignant round opacities; we demonstrate currently used standards and also more advanced techniques that are helpful in evaluating SPNs such as contrast-enhanced CT, PET/CT imaging and also pathologic sampling with biopsy or surgical resection.We also summarize the methods of evaluating and managing SPNs based on the latest guidelines from the Fleischner Society and American College of Chest Physicians.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Military Institute of Medicine, Warsaw, Poland.

ABSTRACT
The solitary pulmonary nodule (SPN) has always been a diagnostic challenge for the radiologists. Currently, with increased utilization of computed tomography (CT) greater number of nodules is being discovered, with numerous indeterminate lesions, which frequently cannot be immediately classified into benign or malignant category.In this article we review the imaging features of benign and malignant round opacities; we demonstrate currently used standards and also more advanced techniques that are helpful in evaluating SPNs such as contrast-enhanced CT, PET/CT imaging and also pathologic sampling with biopsy or surgical resection.We also summarize the methods of evaluating and managing SPNs based on the latest guidelines from the Fleischner Society and American College of Chest Physicians.

No MeSH data available.


Related in: MedlinePlus