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Solitary Pulmonary Nodule (cont.)

Solitary Pulmonary Nodule Symptoms

Most persons with solitary pulmonary nodule do not experience symptoms. Generally, solitary pulmonary nodule is detected as an incidental finding.

Approximately 20% to 30% of all cases of lung cancer appear as solitary pulmonary nodules on chest X-ray films. Therefore, the goal of investigating an solitary pulmonary nodule is to differentiate a benign growth from a malignant growth as soon and as accurately as possible.

Solitary pulmonary nodules should be considered potentially cancerous until proven otherwise.

People should always communicate openly and honestly with their health care professional about their history and risk factors.

The following features are important when assessing whether the solitary pulmonary nodule is benign or malignant.

  • Age: Risk of malignancy increases with age.
    • Risk of 3% at age 35 to 39 years
    • Risk of 15% at age 40 to 49 years
    • Risk of 43% at age 50 to 59 years
    • Risk of greater than 50% in persons older than 60 years
  • Smoking history: A history of smoking increases the chances of the solitary pulmonary nodule being malignant.
  • Prior history of cancer: People with a history of cancer in other areas of the body have a greater chance that the solitary pulmonary nodule is malignant.
  • Occupational risk factors for lung cancer: Exposure to asbestos, radon, nickel, chromium, vinyl chloride, and polycyclic hydrocarbons increases the chance that the solitary pulmonary nodule is malignant.
  • Travel history: People who have traveled to areas with endemic mycosis (for example, histoplasmosis, coccidioidomycosis, blastomycosis) or a high prevalence of tuberculosis have a higher chance of the solitary pulmonary nodule being benign.
  • People who have a history of tuberculosis or pulmonary mycosis have a greater chance of the solitary pulmonary nodule being benign.

Solitary Pulmonary Nodule Diagnosis

Blood tests are not diagnostic. However, the following tests may indicate whether the solitary pulmonary nodule is benign or malignant:

  • Anemia (low levels of hemoglobin) or an elevated erythrocyte sedimentation rate (speed at which red blood cells settle in anticoagulated blood) may indicate an underlying cancer or an infectious disease.
  • Elevated levels of liver enzymes, alkaline phosphatase, or serum calcium may indicate that the solitary pulmonary nodule is cancerous and spreading or that cancer is spreading from other parts of the body to the lung.
  • Persons who have histoplasmosis or coccidioidomycosis may have high levels of immunoglobulin G and immunoglobulin M antibodies specific to these fungi.
A tuberculin skin test is a simple skin test used to help determine whether the solitary pulmonary nodule has been caused by the bacteria Mycobacterium tuberculosis. The test involves injecting the tuberculin antigen (a substance that triggers the immune system to produce cells [antibodies] that attack and try to destroy the antigen) into the skin and observing the body's response. If the solitary pulmonary nodule has been caused by tuberculosis, the injection site swells and reddens.
Medically Reviewed by a Doctor on 2/9/2016

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