Lung Nodule FAQs

What is a lung nodule?

A lung nodule or pulmonary nodule refers to a small shadow or spot in the lungs seen on a scan and measuring less than 3 cm in size. Usually this is on a CT scan but sometimes nodules are seen on other types of scans such as X-rays, MRIs or PET scans. Although this may have been a CT scan of the chest, some portions of the lungs are often scanned as part of investigations for the heart, abdomen, breast, spine etc. Nodules are commonly picked up incidentally and often do not have any symptoms associated with them.

Are lung nodules cancer?

There are many potential causes of a lung nodule or multiple lung nodules. This can include cancer, infection, inflammatory disorders and benign processes. It is important to stress that the vast majority of nodules are benign and of no concern. However it is possible for nodules to be early cancers and it is of critical important to interpret the CT accurately in order to differentiate and make an accurate diagnosis.

What size of nodule is concerning?

We commonly get asked if a nodule below 1 cm in size is concerning. The simple answer is it depends. In most cases small nodules are actually intrapulmonary lymph nodes (see below) and not concerning and can be safely ignored. If there are atpyical features follow up scans are recommended. Although a smaller size may suggest that a nodule is not cancer, we know that large nodules were once small nodules so we aim to carefully scrutinise each nodule. We feel is critically important to take into account the patient’s medical history. We have seen several nodules below 1cm which we have had suspicions about which after performing a biopsy were proven to be cancer.

What are intrapulmonary lymph nodes?

A lymph node is commonly know as a “gland.” Most people are familiar with the glands in your neck that get swollen if you have a cough or cold. In fact you have similar, smaller glands all over your body. The lungs are no exception -the term intrapulmonary meaning “within the lung”. These are extremely commonly seen on scans. If the diagnosis can be confidently made then further testing it not necessary avoiding inconvenience and worry. Sometimes these lymph nodes can have atypical features making it more difficult to definitely say they are not a n early cancer, in which follow up scans or other testing would be recommended depending on the size of the nodule.

How can I send my scans to Heart&Lung Health for a review?

There are two ways we can review your scans:

If you know the name of the hospital or NHS trust in which the scan was performed we can ask for this to be transferred over to us to review. This process usually takes a few days.

The second method is you can upload your own images to our secure online portal. You will need to obtain a CD/DVD of the images of the scan – all hospitals/clinics will provide this although you may have to pay a small fee. We have an agreement with certain hospitals where they will be able to upload them directly with your consent.

Please contact us for more information.

Will my doctor be annoyed I have sought a second opinion?

Second opinions are a fact of life in medicine and something we view as an important part of providing the high possible quality of care to patients. We are regularly asked to provide an expert second opinion on scans in both the NHS and private sector.

Please read this article by the former President of the Royal College of Radiologists outlining why second opinions are important.

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