Pulmonary Nodule

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KEY POINTS

• A pulmonary nodule is a small spot on your lung that is seen on a chest X-ray.
• Treatment depends on what tests show as the cause of the nodule. Your healthcare provider may do X-rays to watch the nodule over time to see if it changes in shape or size. You may have surgery if the nodule may be cancer or is causing problems.
• Follow the full course of treatment prescribed by your healthcare provider. Make sure you know when you should come back for a checkup.

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What is a pulmonary nodule?

A pulmonary nodule is a small spot on your lung that is seen on an X-ray. It may be a scar from an earlier infection. A pulmonary nodule may be cancer, though most pulmonary nodules are benign (not cancer). Pulmonary nodules are usually very small in size.

What is the cause?

The exact cause of a pulmonary nodule is not always known. A pulmonary nodule may be from:

• Scars from a lung infection that you no longer have
• Infected or inflamed (red and swollen) areas that have formed a lump or mass
• Fibrosis (dense scarring) from an autoimmune disease such as rheumatoid arthritis
• Lung cancer

What are the symptoms?

You may not have any symptoms. If you do have symptoms, they may include:

• Coughing
• Wheezing
• Shortness of breath
• Coughing up blood

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. A pulmonary nodule usually is found when you have a chest X-ray or a CT scan of the chest for a different reason. You may have more than one pulmonary nodule.

• You may have blood tests to check for an infection.
• Your healthcare provider may need more information to decide if the pulmonary nodule is cancer or is benign. Other tests may include:
  • A CT scan of the chest if the pulmonary nodule was seen on an X-ray of the chest
  • An ultrasound, which uses sound waves to show pictures of the lungs
  • A biopsy to remove a small sample of tissue for testing
  • A chest endoscopy (mediastinoscopy), which uses a slim, lighted tube to look inside your upper chest
  • A bronchoscopy, which uses a flexible, lighted tube passed through your mouth and down into your lungs to see abnormal areas
  • A PET scan, which is a series of detailed pictures that is taken after your healthcare provider injects a small amount of radioactive chemical into your blood

How is it treated?

• If the pulmonary nodule is a scar from an earlier infection that you no longer have, you may not need treatment.
• You may have chest X-rays or CT scans in the future so your healthcare provider can watch for changes in the shape and size of the pulmonary nodule.
• You may need medicine if bacteria, fungus, or a parasite is causing an active infection.
• You may need treatment for a medical condition that is causing inflammation.
• You may need surgery if your pulmonary nodule is not cancer but is large or is causing other problems.
• Your healthcare provider will treat you based on your diagnosis and overall health if the pulmonary nodule is cancer.
• Your healthcare provider may advise you to quit smoking and make changes in your environment so you are not around things that irritate your lungs.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Take care of your health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet and try to keep a healthy weight. If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink. Learn ways to manage stress.
• If you smoke, try to quit. Talk to your healthcare provider about ways to quit smoking.
• Get a flu shot as soon as it is available in the fall to protect against flu.
• Ask your healthcare provider if you should get the pneumococcal shot. This shot helps prevent serious complications of pneumonia, such as an infection of the blood or brain.
• Contact your healthcare provider if you have new or worsening symptoms.
• Ask your provider:
  • How and when you will get your test results
  • How long it will take to recover
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them
• Make sure you know when you should come back for a checkup.