Solitary pulmonary nodule
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A solitarySolitary pulmonary nodule (SPN) is defined as a round or oval opacity smaller than 30mm30 mm in diameter. It is completely surrounded by pulmonary parenchyma 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
- should not be linear or angular
- a mass >30mm is usually a bronchogenic carcinoma
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
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congenital
- arteriovenous malformation
- lung cyst
- bronchial atresia with mucoid impaction
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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
See also
-<p>A <strong>solitary pulmonary nodule (SPN) </strong>is defined as a round or oval opacity smaller than 30mm in diameter. It is completely surrounded by pulmonary parenchyma and is not associated with <a title="Lymphadenopathy" href="/articles/lymph-node-enlargement">lymphadenopathy</a>, atelectasis, or pneumonia <sup>9</sup>.</p><p>Questions to ask when you want to approach a<strong> solitary pulmonary nodule</strong> :</p><ul>- +<p><strong>Solitary pulmonary nodule (SPN) </strong>is defined as a round or oval opacity smaller than 30 mm in diameter. It is completely surrounded by pulmonary parenchyma and is not associated with <a href="/articles/lymph-node-enlargement">lymphadenopathy</a>, atelectasis, or pneumonia <sup>9</sup>.</p><p>Questions to ask when you want to approach a<strong> solitary pulmonary nodule</strong> :</p><ul>
-<li><a href="/articles/lung_abscess">lung abscess</a></li>- +<li><a href="/articles/lung-abscess">lung abscess</a></li>
-<li><a href="/articles/pulmonary_arteriovenous_malformation">arteriovenous malformation</a></li>- +<li><a href="/articles/pulmonary-arteriovenous-malformation">arteriovenous malformation</a></li>
-<a href="/articles/bronchial_atresia">bronchial atresia</a> with mucoid impaction</li>- +<a href="/articles/bronchial-atresia">bronchial atresia</a> with mucoid impaction</li>
-<li><a href="/articles/pulmonary_embolism">pulmonary infarct</a></li>-<li>intrapulmonary lymph node</li>- +<li><a href="/articles/pulmonary-embolism">pulmonary infarct</a></li>
- +<li><a href="/articles/intrapulmonary-lymph-nodes">intrapulmonary lymph node</a></li>
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Case 31: fat containing
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Image 2 CT (non-contrast) ( update )
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Nipple shadow -: on right