What to do if you find lung nodules during a physical examination?

Pulmonary nodules usually refer to round or oval lesions that appear in the lungs, and their diameter is usually less than 3 cm. Studies have reported the prevalence of pulmonary nodules in people aged 40 to 75 in northern my country. 26% of the population have detectable pulmonary nodules, of which about 15% can detect pulmonary nodules smaller than 0.5 cm; about 9.5% can detect non-solid pulmonary nodules of 0.5 to 3 cm; and about 1.7% can detect solid pulmonary nodules of 0.1 to 3 cm. When people find pulmonary nodules during lung screening, most of them will have a certain degree of concern. In fact, most pulmonary nodules are benign, but some may be malignant, that is, lung cancer. After the discovery of pulmonary nodules, it is important to conduct further examinations and evaluations to determine their nature.

Follow-up management strategy for pulmonary nodules:

1. The average diameter of pure ground glass density nodules is less than 8 mm, or the average diameter of the solid components of solid nodules/partially solid nodules is less than 6 mm.

It is recommended to proceed to the next year screening.

2. The average diameter of the detected pure ground glass density nodules is not less than 8mm and less than 15mm, or the average diameter of the solid components of the solid nodules/partially solid nodules is not less than 6mm and less than 15mm.

It is recommended to re-examine after 3 months. If the nodule increases in size during the 3-month re-examination, a multidisciplinary consultation (MDT to HIM) is recommended to decide whether clinical intervention should be performed.

If the nodule does not change, it is recommended to proceed to screening next year.

3. The average diameter of the solid component of the detected pure ground glass density nodules or solid nodules/partially solid nodules is not less than 15 mm.

The following two options are recommended.

Option 1: Conduct anti-inflammatory treatment or observation first, and then recheck after 1 month.

During the follow-up examination, if the nodule is completely absorbed, it is recommended to proceed to the next year's screening;

If the nodule is partially absorbed, it is recommended to recheck after 3 months.

If the nodule does not grow larger after partial absorption during the reexamination, it is recommended to proceed to the next annual screening;

If the nodule is partially absorbed and then increases in size, a multidisciplinary consultation is recommended to decide whether clinical intervention is necessary;

If the nodule does not shrink, a multidisciplinary consultation (MDTtoHIM) is recommended to decide whether to perform clinical intervention or reexamine after 3 to 6 months.

Option 2: Solid nodules/partial solid nodules, biopsy or positron emission tomography (PET-CT) examination.

If positive, multidisciplinary consultation MDTtoHIM is recommended to decide whether clinical intervention should be performed;

If the nodule is negative or uncertain, it is recommended to re-examine after 3 months. If the nodule remains unchanged or increases in size during the re-examination, a multidisciplinary consultation MDTtoHIM is recommended to decide whether clinical intervention is necessary.

If the nodule shrinks, it is recommended to proceed to screening next year.

annotation:

① Nodule enlargement: refers to an increase in diameter of not less than 2.0mm.

②Positive PET-CT examination: refers to increased metabolism and radioactive uptake higher than the lung background.

③ Positive sputum cytology: refers to the discovery of malignant or suspected malignant tumor cells in sputum.

④Clinical intervention refers to surgery, radiofrequency ablation, and SBRT.

When lung nodules are found during the initial screening, the key is to stay calm and follow the doctor's advice. Through comprehensive understanding, reasonable response and scientific follow-up strategies, lung nodules can be better managed and potential health risks can be reduced.