Lung nodules, or masses, are small growths in the lungs that are often detected during a chest X-ray or CT scan. They are usually smaller than three centimeters in diameter, and when they are larger than that, they are referred to as lung masses. While these growths can be a cause for concern, it's important to note that most lung nodules are noncancerous (benign) and are often the result of past infections. However, a small percentage could be cancerous (malignant) or could become cancerous over time.
Lung nodules can be caused by a variety of factors. These include:
Infections: Many lung nodules, particularly those that are benign, are caused by previous lung infections like tuberculosis or lung abscess.
Non-Infectious Conditions: Certain non-infectious disorders like sarcoidosis, granulomatosis with polyangiitis, or rheumatoid arthritis can cause nodules to form in the lungs.
Neoplasms: These are abnormal growths that can be benign or malignant. Benign neoplasms include hamartomas and fibromas, while malignant neoplasms may include lung cancer or metastases from cancer in other parts of the body.
Most lung nodules do not cause symptoms and are often discovered incidentally during imaging tests for other conditions. However, if they become large enough or if they are due to cancer, symptoms may include coughing, shortness of breath, chest pain, and coughing up blood.
The diagnosis usually involves imaging tests such as chest X-rays or CT scans. A PET scan or biopsy may be needed if the doctor suspects cancer.
The treatment approach for lung nodules or masses largely depends on the underlying cause.
Monitoring
If a nodule is small and likely benign, the doctor may recommend a watch-and-wait approach. Regular follow-up imaging tests will be done to monitor the nodule for any changes in size or appearance.
SuperDimension Electromagnetic Navigation Bronchoscopy
This is a minimally invasive procedure used to help physicians gain access to difficult-to-reach areas of the lungs. This technology allows the physician to navigate through the bronchial pathways of the lungs using a visual 3D bronchial map. Physicians are then able to navigate to a desired location(s) within the lung for biopsy or to mark location(s) needed for treatment. This procedure aids physicians with diagnosis of many lung diseases and is also used to help prepare for targeted treatment.
Endobronchial Ultrasound
This is a form of ultrasound that allows your doctor to both look inside of your lungs and take samples to help diagnose lung cancer, infections, and other possible diseases. A small tude is passed through your lungs with a tiny camera allowing the doctor to view live imaging of the surface of the lungs, airways, blood vessels and lymph nodes. Being able to internally view potential areas of concern can help the doctor to locate the best places to take samples for testing. Most commonly EBUS is performed on patients under moderate sedation or general anesthesia and patients are generally able to recover quickly and can go home the same day.
PleurX Catheter
The PleurX catheter is a very thin tube used to drain the fluid buildup caused by pleural diffusion. Pleural effusion is when excess fluid accumulates in the pleural cavity, a fluid-filled space that surrounds the lungs. This excess fluid can make breathing more difficult as it limits the expansion of the lungs. It causes shortness of breath and chest pain. Placement of the PleurX catheter is minimally invasive procedure in which the catheter is inserted into the pleural space through a small incision.
Cryoablation
Cryoablation is a procedure that applies extreme cold to freeze and destroy damaged tissue or tumor cells. This technique has been used for years by physicians but recent advances in technology have allowed physicians to operate in a minimally invasive procedure and allows for physicians to specially target tissue so that nearby healthy tissue is not damaged.