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The Solitary Pulmonary Nodule

  • J. David Godwin

Abstract

At the University of Washington we consider a solitary pulmonary nodule to be a discrete, single lung abnormality with well-defined margins. It can be calcified or cavitary and small or large. We do not exclude a lesion over 4 cm, as some authors do, and we do not exclude a lesion when there is accompanying disease in the lungs, as long as the nodule is distinguishable.

Keywords

Benign Lesion Pulmonary Nodule Primary Lung Cancer Compute Tomog Malignant Nodule 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Good CA, Wilson TW: The solitary circumscribed pulmonary nodule. Study of seven hundred five cases encounteredroentgenologically in a period of three andone-half years. JAMA 166:210–215, 1958CrossRefGoogle Scholar
  2. 2.
    Jackman RJ, Good CA, Clagett QT, et al: Survival rates in peripheral bronchogenic carcinomas up to four centimeters in diameter presenting as solitary pulmonary nodules. J Thorae Cardiovase Surg 57: 1–8, 1969Google Scholar
  3. 3.
    Steele JD, Kleitsch WP, Dunn JE Jr, et al: Survival in males with bronchogenic carcinomas resected as asymptomatic solitary pulmonary nodules. Ann Thorae Surg 2:368–376, 1966CrossRefGoogle Scholar
  4. 4.
    Ray JF III, Lawton BR, Magnin GE, et al: The coin lesion story: Update 1976. Twenty years experience with early thoracotomy for 179 suspected malignant coin lesions. Chest 70:332–336, 1976PubMedCrossRefGoogle Scholar
  5. 5.
    Higgins GA, Shields TW, Keehn RJ: The solitary pulmonary nodule. Ten-year follow-up of Veterans Administration- Armed Forces cooperative study. Arch Surg 110:570–575, 1975PubMedCrossRefGoogle Scholar
  6. 6.
    Vance JW, Good CA, Hodgson CH, et al: The solitary circumscribed pulmonary lesion due to bronchogenic carcinoma: A 3-year follow-up study of 94 surgically treated patients. Dis Chest 36:231–237, 1959PubMedGoogle Scholar
  7. 7.
    Lillington GA, Stevens GM: The solitary nodule. The other side of the coin. Chest 70:322–323, 1976PubMedCrossRefGoogle Scholar
  8. 8.
    Moser KM: Solitary pulmonary nodules. JAMA 227: 1167–1168, 1974PubMedCrossRefGoogle Scholar
  9. 9.
    Keagy BA, Starek PJK, Murray GF, et al: Major pulmonary resection for suspected but unconfirmed malignancy. Ann Thorae Surg 38:314–316, 1984CrossRefGoogle Scholar
  10. 10.
    Lillington GA: Pulmonary nodules: Solitary and multiple. Clin Chest Med 3:361–367, 1982PubMedGoogle Scholar
  11. 11.
    Reeder MM, Reed Je: Solitary pulmonary nodule(<4 cm in diameter). JAMA 231:1080–1082,1975PubMedCrossRefGoogle Scholar
  12. 12.
    Meyer TJ: The solitary pulmonary nodule. An aggressive workup. Postgrad Med 73:66–75,1983PubMedGoogle Scholar
  13. 13.
    Cohen M, Slabaugh R, Smith JA: Unusual nonmetastatic nodules in the lungs of children with cancer. Clin Radiol 33:57–59, 1982PubMedCrossRefGoogle Scholar
  14. 14.
    Khouri NF, Meziane MA, Zerhouni EA, et al: The solitary pulmonary nodule. Assessment, diagnosis, and management. Chest 91: 128–133, 1987PubMedCrossRefGoogle Scholar
  15. 15.
    Toomes H, Delphendahl A, Manke HG, Vogt-MoYkopf I: The coin lesion of the lung. A review of 955 resected coin lesions. Cancer 51:534–537, 1983PubMedCrossRefGoogle Scholar
  16. 16.
    Steele JD: The solitary pulmonary nodule. Report of a cooperative study of resected asymptomatic solitary pulmonary nodules in males. J Thorae Cardiovase Surg 46:21–39, 1963Google Scholar
  17. 17.
    Steele JD: The Solitary Pulmonary Nodule. Springfield, IL, Charles C Thomas, 1964Google Scholar
  18. 18.
    Holin SM, Dwork RE, Glaser S, Rikli AE, Stocklen JB: Solitary pulmonary nodules found in a community-wide chest roentgenographic survey. A five-year follow-up study. Am Rev Tubere Pulm Dis 79:427–439, 1959Google Scholar
  19. 19.
    Trunk G, Gracey DR, Byrd RB: The management and evaluation of the solitary pulmonary nodule. Chest 66:236–239, 1974PubMedCrossRefGoogle Scholar
  20. 20.
    Francis DB, Zimmerman PV: Intrapulmonary coin lesions: The changing patterns. Med J Aust 144:122–123,1986PubMedGoogle Scholar
  21. 21.
    Drevvatne T, Frimann-Dahl J: Peripheral bronchial carcinomas: A radiological and pathological study. Br J Radiol 34:180–186, 1961PubMedCrossRefGoogle Scholar
  22. 22.
    Cummings SR, Lillington GA, Richard RJ: Estimating the probability of malignancy in solitary pulmonary nodules. A Bayesian approach. Am Rev Respir Dis 134:449–452,1986PubMedGoogle Scholar
  23. 23.
    Fletcher EC, Levin DC: Flexible fiberoptic bronchoscopy and fluoroscopically guided trans bronchial biopsy in the management of solitary pulmonary nodules. West J Med 136:477–483, 1982PubMedGoogle Scholar
  24. 24.
    Wallace JM, Deutsch AL: Flexible fiberoptic bronchoscopy and percutaneous needle lung aspiration for evaluating the solitary pulmnary nodule. Chest 81:665–671,1982PubMedCrossRefGoogle Scholar
  25. 25.
    Lillington GA: The solitary pulmonary nodule-1974. Am Rev Respir Dis 110:699–707, 1974PubMedGoogle Scholar
  26. 26.
    Marchand P: Mediastinoscopy.S Afr Med J 46:285–290,1972PubMedGoogle Scholar
  27. 27.
    Cahan WG, Castro EB: Significance of a solitary lung shadow in patients with breast cancer. Ann Surg 181: 137–143, 1975PubMedCrossRefGoogle Scholar
  28. 28.
    Cahan WG, Shah JP, Castro EB: Benign solitary lung lesions in patients with cancer. Ann Surg 187:241–244, 1977CrossRefGoogle Scholar
  29. 29.
    Bateson EM: Analysis of 155 solitary lung lesions illustrating the differential diagnosis of mixed tumours of the lung. Clin Radiol 16:51–65, 1965PubMedCrossRefGoogle Scholar
  30. 30.
    Jensen KG, Schiodt T: Growth conditions of hamartoma of the lung. A study based on 22 cases operated on after radiographic observation for from one to 18 years. Thorax 13:233–237, 1958PubMedCrossRefGoogle Scholar
  31. 31.
    Bateson EM: The solitary circumscribed bronchogenic carcinoma. A radiological study of 100 cases. Br J Radiol 37:598–607, 1964PubMedCrossRefGoogle Scholar
  32. 32.
    Heitzman ER: Bronchogenic carcinoma: Radiologicpathologic correlations. Semin Roentgenol 12:165–174,1977PubMedCrossRefGoogle Scholar
  33. 33.
    Crow J, Slavin G, Kreel L: Pulmonary metastasis: A pathologic and radiologic study. Cancer 47:2595–2602, 1981PubMedCrossRefGoogle Scholar
  34. 34.
    Libshitz HI, Baber CE, Hammond CB: The pulmonary metastases of choriocarcinoma. Obstet Gynecol 49:412–416, 1977PubMedGoogle Scholar
  35. 35.
    Rigler LG, Heitzman ER: Planigraphy in the differential diagnosis of the pulmonary nodule. With particular reference to the notch sign of malignancy. Radiology 65:692–702, 1955PubMedGoogle Scholar
  36. 36.
    Huston J III, Muhm JR: Solitary pulmonary opacities: Plain tomography. Radiology 163:481–485, 1987PubMedGoogle Scholar
  37. 37.
    Davis EW, Peabody JW Jr, Katz S: The solitary pulmonary nodule: A ten-year study based on 215 cases. J Thorac Cardiovasc Surg 32:728–771, 1956Google Scholar
  38. 38.
    Hill CA: “Tail” signs associated with pulmonary lesions: Critical reappraisal. AJR 139:311–316, 1982PubMedGoogle Scholar
  39. 39.
    Good GA: The solitary pulmonary nodule: A problem of management. Radiol Clin North Am 1:429–438, 1963Google Scholar
  40. 40.
    London SB, Winter WJ: Calcification within carcinoma oflung. Report of a case with isolated pulmonary nodule. Arch Intern Med 94: 161–165, 1954CrossRefGoogle Scholar
  41. 41.
    O’Keefe ME Jr, Good CA, McDonald JR: Calcification in solitary nodules of the lung. AJR 77:1023–1033,1957Google Scholar
  42. 42.
    Austin JHM, Sagel SS: Tomography, in Sagel SS (ed): Special Procedures in Chest Radiology. Philadelphia, WB Saunders Co, 1976Google Scholar
  43. 43.
    Chasen MH, McCarthy MJ: Pulmonary nodules: Detection of calcification by linear and pi uri directional movement in tomographic study. Radiology 156:589–592 1985PubMedGoogle Scholar
  44. 44.
    Rigler LG: The roentgen signs of carcinoma of the lung. AJR 74:415–428, 1955Google Scholar
  45. 45..
    Nathan MH, Collins VP, Adams RA: Differentiation of benign and malignant pulmonary nodules by growth rate. Radiology 79:221–232, 1962PubMedGoogle Scholar
  46. 46.
    Nathan MH: Management of solitary pulmonary nodules. An organized approach based on growth rate and statistics. JAMA 227:1141–1144,1974PubMedCrossRefGoogle Scholar
  47. 47.
    Raptopoulos V, Schellinger D, Katz S: Computed tomography of solitary pulmonary nodules: Experience with scanning times longer than breath-holding. J Comput Assist Tomogr 2:55–60, 1978PubMedCrossRefGoogle Scholar
  48. 48.
    Siegelman SS, Zerhouni EA, Leo FP, et al: CT of the solitary pulmonary nodule. AJR 135:1–13,1980PubMedGoogle Scholar
  49. 49.
    Siegelman SS, Khouri NF, Leo FP, et al: Solitary pulmonary nodules: CT assessment. Radiology 160:307–312, 1986PubMedGoogle Scholar
  50. 50.
    Holle RH, Cairns J, Mack L, et al: CT scanning of the solitary pulmonary nodule in Seattle. Abstract for American Thoracic Society Meeting, Los Angeles, May 15–18,1982Am Rev Respir Dis 125:78, 1982Google Scholar
  51. 51.
    Godwin JD, Speckman JM, Fram EK, et al: Distinguishing benign from malignant pulmonary nodules by computed tomography. Radiology 144:349–351, 1982PubMedGoogle Scholar
  52. 52.
    Proto A V, Thomas SR: Pulmonary nodules studied by computed tomography. Radiology 156:149–153, 1985PubMedGoogle Scholar
  53. 53.
    Levi C, Gray JE, McCullough EC, et al: The unreliability of CT numbers as absolute values.AJR 139:443–447,1982PubMedGoogle Scholar
  54. 54.
    Zerhouni EA, Spivey JF, Morgan RH, et al: Factors influencing quantitative CT measurements of solitary pulmonary nodules. J Comput Assist Tomogr 61:1075–1087, 1982CrossRefGoogle Scholar
  55. 55.
    Zerhouni EA, Boukadoum M, Siddiky MA, et al: A standard phantom for quantitative CT analysis of pulmonary nodules. Radiology 149:767–773, 1983PubMedGoogle Scholar
  56. 56.
    McCullough EC, Morin RL: CT-number variability in thoracic geometry. AJR 141:135–140, 1983PubMedGoogle Scholar
  57. 57.
    Godwin JD, Fram EK, Cann CE, et al: CT densitometry of pulmonary nodules: A phantom study. J Comput Assist Tomogr 6:254–258, 1982PubMedCrossRefGoogle Scholar
  58. 58.
    Lm JG, Gamsu G, Gordon D, et al: CT nodule densitometry within a frozen human thorax. Presented at the 35th annual meeting of the Association of University Radiologists, March 22–26, 1987, Charleston, South CarolinaGoogle Scholar
  59. 59.
    de Geer G, Gamsu G, Cann C, Webb WR: Evaluation of a chest phantom for CT nodule densitometry. AJR 147:21–25, 1986PubMedGoogle Scholar
  60. 60.
    Sagel SS: The solitary pulmonary nodule: Role of CT. AJR 147:26–27, 1986PubMedGoogle Scholar
  61. 61.
    Zerhouni EA, Stitik FP, Siegelman SS, et al: CT of the pulmonary nodule: A cooperative study. Radiology 160:319–327,1986PubMedGoogle Scholar
  62. 62.
    CannCE, Gamsu G, BimbergFA, etal: Quantification of calcium in solitary pulmonary nodules using single- and dual-energy CT. Radiology 145:493–496, 1982PubMedGoogle Scholar
  63. 63.
    Kruger RA, Armstrong JD, Sorenson JA, et al: Dual energy film subtraction technique for detecting calcification in solitary pulmonary nodules. Radiology 140: 213–219, 1981PubMedGoogle Scholar
  64. 64.
    Lehmann LA, Alvarez RE, Macovski A, et al: Generalized image combinations in dual KVP digital radiography. Med Phys 8:659–667,1981PubMedCrossRefGoogle Scholar
  65. 65.
    Aronberg DJ, Sagel SS: High CT attenuation values of a benign pulmonary nodule. J Comput Assist Tomogr 5:563–564, 1981PubMedCrossRefGoogle Scholar
  66. 66.
    Goldstein MS, Rush M, Johnson P, Sprung CL: A calcified adenocarcinoma of the lung with very high CT numbers. Radiology 150:785–786, 1984PubMedGoogle Scholar
  67. 67.
    StewartJG, MacMahon H, VybomyCJ, PollakER: Dystrophic calcification in carcinoma of the lung: Demonstration by CT. AJR 148:29–30, 1987PubMedGoogle Scholar
  68. 68.
    Niklason LT, Hickey NM, Chakraborty DP, et al: Simulated pulmonary nodules: Detection with dual-energy digital versus conventional radiography. Radiology 160:589–593, 1986PubMedGoogle Scholar
  69. 69.
    Sherrier RH, Chiles C, Johnson GA, Ravin CE, et al: Differentiation of benign from malignant pulmonary nodules with digitized chest radiographs. Radiology 162:645–649, 1987PubMedGoogle Scholar
  70. 70.
    Hickey NM, Niklason LT, Sabbagh E, et al: Dual-energy digital radiograph quantification of calcium in simulated pulmonary nodules. AJR 148:19–24, 1987PubMedGoogle Scholar
  71. 71.
    Fraser RG, Hickey NM, Niklason L T, et al: Calcification in pUlmonary nodules: Detection with dual-energy digital radiography. Radiology 160:595–601, 1986PubMedGoogle Scholar
  72. 72.
    Müller NL, Gamsu G, Webb WR: Pulmonary nodules: Detection using magnetic resonance and computed tomography. Radiology 155:687–690, 1985PubMedGoogle Scholar
  73. 73.
    Westcott JL: Needle aspiration biopsy of pulmonary hilar, and mediastinal masses. Clin Chest Med 5:365– 377, 1984PubMedGoogle Scholar
  74. 74.
    Khouri NF, Stitik FP, Erozan YS, et al: Transthoracic needle aspiration biopsy of benign and malignant lung lesions. AJR 144:281–288, 1985PubMedGoogle Scholar
  75. 75.
    Tisi GM: The solitary pulmonary nodule: Which to resect? Which to follow? Pulm Perspectives 2(3): 1–3, 1985Google Scholar

Copyright information

© Springer-Verlag New York Inc. 1990

Authors and Affiliations

  • J. David Godwin

There are no affiliations available

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