Solitary Pulmonary Nodule Symptoms

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

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

SPNs should be considered potentially cancerous until proven otherwise.

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

The following features are important when assessing whether the SPN is benign or malignant.

• Age: Risk of malignancy increases with age.
  
  
  • Risk of 3% at age 35-39 years
  
  
  
  • Risk of 15% at age 40-49 years
  
  
  
  • Risk of 43% at age 50-59 years
  
  
  
  • Risk of greater than 50% in persons older than 60 years
     
• Smoking history: A history of smoking increases the chances of the SPN being malignant.



• Prior history of cancer: People with a history of cancer in other areas of the body have a greater chance that the SPN is malignant.



• Occupational risk factors for lung cancer: Exposure to asbestos, radon, nickel, chromium, vinyl chloride, and polycyclic hydrocarbons increases the chance that the SPN is malignant.



• Travel history: People who have traveled to areas with endemic mycosis (eg, histoplasmosis, coccidioidomycosis, blastomycosis) or a high prevalence of tuberculosis have a higher chance of the SPN being benign.



• People who have a history of tuberculosis or pulmonary mycosis have a greater chance of the SPN being benign.