Download and print as a PDF
DownloadA pulmonary nodule is a small growth in your lung. On a CT scan or chest x-ray it looks like an area of roundish shadowing less than 3cm (about 1 inch) across. It does not cause any symptoms.
Nodules are sometimes seen 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 usually small, a biopsy (a test performed to obtain a sample of the nodule) may be very difficult. Instead we keep an eye on the nodule by repeating the CT scan after a certain amount of time to see whether it grows or changes shape.
Benign (non cancerous) nodules grow very slowly, or may not grow at all. Malignant (cancerous) nodules will eventually grow although this can happen very slowly over months or years.
Pulmonary (lung) nodules are very common. About 1 in 4 older people who smoke or used to smoke have nodules that are seen on a CT scan. People who have never smoked may also have nodules that are seen on a CT scan.
The majority of lung nodules are benign (non cancerous). Some nodules are tiny areas of previous inflammation in the lung, or areas of scarring from previous lung infections. Some are normal lymph glands in the lung. They are very common in people who have had TB (Tuberculosis) and can occur in people who have had other conditions such as rheumatoid arthritis.
In a small number of people the nodule can be a very early lung cancer or occasionally a secondary cancer that has spread from elsewhere in the body.
The chest specialist team will discuss your information and CT scan at a team meeting with other specialist doctors and nurses. Sometimes it is clear on the CT scan that this nodule is a benign lymph gland or is a stable nodule that had been present on previous CT scans you may have had over the years, in which case you don’t need to have any further scans or investigations.
More often a repeat CT scan will be arranged to monitor the nodule. This is usually done three months after your first scan. Usually it will be necessary to continue this surveillance with CT scans every year for a number of years. This is called a surveillance plan. The number of scans you have will depend on the characteristics of the nodule as well as:
In some cases you may have another type of scan arranged called a PET-CT scan.
If the nodule grows or changes in any way then we may arrange for you to have further tests.
We will initially get in touch by letter when your case is brought to our attention and we first discuss your CT scan. This will outline the outcome of our assessment and the proposed surveillance plan. We routinely offer an appointment after your second scan if you have not been seen in a chest clinic before. This will be an opportunity to talk again about the nodule and the surveillance plan with you, and make sure that you are happy with it.
You will then receive appointments to have follow-up scans. Unless you prefer otherwise, your chest specialist will send you a letter with the follow-up CT scan result and the time frame of your next CT scan.
Dr Rawya Ahmed
Respiratory Department, Nigel Porter Unit
Royal Sussex County Hospital
Telephone: 01273 696955, extension 3107.
This information is intended for patients receiving care in Brighton & Hove or Haywards Heath.
The information here is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.
Review Date: November 2022
