Solitary pulmonary nodule
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Solitary pulmonary nodule (SPN) is defined as a relatively well defined round or oval pulmonary parenchymal lesion equal or smaller than 30 mm in diameter. It is surrounded by pulmonary parenchyma and/or visceral pleura and is not associated with lymphadenopathy, atelectasis, or pneumonia 9.
Questions to ask when you want to approach a solitary pulmonary nodule :
- is the lesion solitary?
- is it intrapulmonary?
- is the lesion a nodule?
- should be a discrete round oval opacity 4-30 mm in diameter; a lesion >30mm is defined as a mass, not a nodule
- should not be linear or angular
Differential diagnosis
There are many causes of solitary pulmonary nodules (SPN)'s, including:
- neoplastic
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inflammatory
- granuloma
- lung abscess
- rheumatoid nodule
- pulmonary inflammatory pseudotumour: plasma cell granuloma
- small focus of pneumonia: round pneumonia
- congenital
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miscellaneous
- pulmonary infarct
- intrapulmonary lymph node
- mucoid impaction
- pulmonary haematoma
- pulmonary amyloidosis
- normal confluence of pulmonary veins
Mimics
- nipple shadow
- cutaneous lesion (e.g. wart, mole)
- rib fracture or other bone lesion
- vanishing pseudotumour of congestive heart failure
- summation of markings
- artifact
See also
-<li>should be a discrete round oval opacity 4-30 mm in diameter; a lesion >30mm is a mass not a nodule</li>- +<li>should be a discrete round oval opacity 4-30 mm in diameter; a lesion >30mm is defined as a mass, not a nodule</li>
-</ul><h4>Differential diagnosis</h4><p>There are many causes of <strong>solitary pulmonary nodules (SPN)'s</strong>, including:</p><ul>- +</ul><h4>Differential diagnosis</h4><p>There are many causes of <strong>solitary pulmonary nodules</strong>, including:</p><ul>
-<a href="/articles/carcinoid-tumours-1">carcinoid tumours</a><ul>- +<a href="/articles/carcinoid-tumour-2">carcinoid tumours</a><ul>
-<a href="/articles/bronchial-atresia">bronchial atresia</a> with mucoid impaction</li>- +<a href="/articles/bronchial-atresia">bronchial atresia</a> with <a title="Mucoid impaction (lung)" href="/articles/mucoid-impaction-lung-1">mucoid impaction</a>
- +</li>
-<li>mucoid impaction</li>- +<li><a title="Mucoid impaction (lung)" href="/articles/mucoid-impaction-lung-1">mucoid impaction</a></li>
-<li>rib fracture or other bone lesion</li>-<li>vanishing <a href="/articles/pulmonary-pseudotumour">pseudotumour</a> of congestive heart failure</li>- +<li>
- +<a title="Rib fractures" href="/articles/rib-fractures">rib fracture</a> or other bone lesion</li>
- +<li>vanishing <a href="/articles/pulmonary-pseudotumour">pseudotumour</a> of <a title="Congestive heart failure" href="/articles/congestive-cardiac-failure">congestive heart failure</a>
- +</li>
-<li><a href="/articles/coin-lesion">coin lesion</a></li>-<li><a href="/articles/fleischner-society-pulmonary-nodule-recommendations">Fleischner society criteria for incidental pulmonary nodules</a></li>- +<li><a href="/articles/coin-lesion-lung">coin lesion</a></li>
- +<li><a href="/articles/fleischner-society-pulmonary-nodule-recommendations-1">Fleischner society criteria for incidental pulmonary nodules</a></li>
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Solitary pulmonary nodules (SPN(SPNs)'s