Lung nodules are small, solid lumps in the lung that can be seen on a chest X-ray. They are usually benign (not cancerous), but some people have lung nodules due to cancer. They typically do not cause symptoms, and most people with them do not need treatment.
A lung nodule is a mass of tissue that may be solid or fluid filled. It can be associated with cough, shortness of breath and chest pain.
Lung nodules are common and usually don’t cause any problems. Most disappear over time without treatment. However, if they’re causing symptoms, you should see a doctor or specialist, who will refer you to a hospital if necessary.
A lung nodule can cause problems if it compresses surrounding tissue, including the chest wall and blood vessels that supply oxygen to your heart and brain (the arteries). This can lead to shortness of breath, fainting spells (syncope), dizziness or lightheadedness when standing up quickly (orthopnea).
A lung nodule is a small growth, usually less than 2 centimetres (just over 1 inch) in diameter, found in the lung or chest wall tissue. Nodules are generally detected through a chest X-ray or C.T. scan.
The most common types of nodules are:
Solitary lung nodule
A solitary lung nodule appears on a chest X-ray or C.T. scan but has no associated symptoms. This nodule is often diagnosed during routine screenings for cancer or other conditions, such as tuberculosis.
Pleural effusion (exudate)
Excess fluid collects in the lining surrounding your lungs (pleura). This lung nodule is typical and usually not serious, but it can indicate other illnesses such as pneumonia or cancer.
Symptomatic lung nodules
Symptomatic lung nodules cause symptoms such as shortness of breath. These can be further classified as malignant (cancerous), which includes both non-small cell and small cell lung carcinomas, and non-malignant (benign).
The main sign of lung nodules is a new painless mass in your chest or back. You might also have shortness of breath or coughing up blood.
Most people who have a lung nodule have no symptoms. When symptoms occur, they’re often associated with advanced disease or cancer. These include:
- Chest pain, especially when coughing or deep breathing
- Coughing up blood (hemoptysis)
- A cough that doesn’t go away with treatment and persistent chest pain in one area that gets worse when you cough or breathe deeply (pleurisy).
- Night sweats and fevers.
- Loss of appetite, weight loss, and fatigue (weakness).
- If multiple lung nodules exist, the symptoms can be more severe; you may have trouble breathing and feel short of breath even when resting.
The most common cause of lung nodules is chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. These conditions damage the lungs, so they can’t clear out mucus properly, which leads to infections and inflammation in the airways.
The most common cause of lung nodules is an infection, including those caused by bacteria and viruses.
Other causes include:
- Respiratory infections like pneumonia or influenza.
- Allergies such as asthma or allergies to pollen or mould spores.
- Conditions include tuberculosis, fungal infections and viral infections like influenza or parainfluenza.
- Granulomas from inhaled foreign bodies, such as asbestos; this can also be caused by certain diseases such as sarcoidosis, Crohn’s disease and Wegener’s granulomatosis.
- Lung nodules can also be caused by cancerous conditions like lymphoma and bronchogenic carcinoma.
Lung nodules are typically detected by chest X-ray. Chest CT scans and PET scans can also be used to detect lung nodules, but these tests are more expensive and may not be covered by insurance.
If the doctor suspects you have lung cancer, he or she will order additional tests such as a C.T. or PET scan. These tests can help determine whether the nodule is cancerous.
Lung nodules are often seen on a chest x-ray, but sometimes they can be challenging to detect. Tiny nodules in lungs that aren’t causing problems may not need treatment. Large and diffuse lung nodules can cause symptoms, so they may need treatment.
The size of a nodule is measured in millimetres (mm). For example, a 1-cm nodule is about the size of a dime or a penny. A 3-cm nodule would be about the size of an egg yolk or smaller than the palm of your hand.
A doctor who specializes in diagnosing and treating lung diseases (pulmonologist) can tell you whether your pulmonary nodules are benign (noncancerous) or malignant (cancerous).
The treatment of lung nodules depends on the underlying cause. Suppose a lung nodule is found incidentally, meaning that it was not suspected prior to the C.T. scan or other imaging study.
In that case, follow-up with a chest radiograph may be recommended. If there are no other symptoms or signs of disease, this is the only treatment required.
Treatment for lung cancer or metastatic nodules in the lungs usually involves surgery for early-stage cancers and chemotherapy for advanced-stage cancers. Radiation therapy may also be used in some cases.
In some cases, noncancerous (benign) lung nodules may be treated with medicines that shrink them. These medications include steroids and other anti-inflammatory drugs.
In some instances, these medications may also help prevent lung cancer from developing in a lung nodule.
If a lung nodule is very large or if it causes symptoms such as shortness of breath, it may need to be removed surgically (surgically excised).
This procedure is called a lobectomy — surgical removal of part of the lung — and can be done through open surgery (through an incision in your chest) or through keyhole surgery (also known as thoracoscopic surgery).
Lung cancer treatment
If the doctor determines that the growth is malignant (cancerous), additional testing will be needed to determine what stage your cancer is in.
After staging, doctors recommend treatments based on your specific needs and prognosis.
Complete resection (pneumonectomy)
A pneumonectomy may be necessary if the entire lung nodule cannot be removed surgically without harming other organs or structures.
This operation removes part or all of one lung and the tumour mass.
It is essential to understand that not all nodules are cancerous. Some will turn out benign (noncancerous), and some may be malignant (cancerous). A biopsy is the best way to determine whether a lesion is benign or malignant.
These benign respiratory tract abnormalities can cause severe problems for many if left unaddressed. Some are tenacious, others are easily treatable via surgical excision, but all require awareness of their existence to prevent recurrent respiratory infections.
To avail of a hassle-free lung nodules consultation, visit the C.K. Birla Hospital or book an appointment with Dr Kuldeep Kumar Grover, who will provide you with prompt prognosis and treatment. Our highly-qualified healthcare professionals provide diagnosis and therapy using state-of-the-art facilities and cutting-edge technologies.