What Causes Solitary Pulmonary Nodule (SPN)?

Solitary Pulmonary Nodules or SPN* may be caused by a host of reasons including: Adenocarcinoma, Abscess, Coccidioidoma, Hemartoma, Neurilemoma, Pulmonary arteriovenous malformation, and Squamous cell carcinoma.

It must be noted, however, that not all solitary pulmonary lung nodules are malignant, and not all pulmonary opacities (lung nodules) are solitary pulmonary nodules. For example, if solitary pulmonary opacities are caused by adenopathy or atelectasis, they are not considered to be solitary pulmonary nodules.

Solitary Pulmonary Nodule Diagnosis:

Considering that most SPNs are typically asymptomatic, nearly all solitary pulmonary nodules are detected accidentally on a chest-radiograph. Once a solitary pulmonary/lung nodule is detected, the subsequent diagnostic effort focuses on determining whether or not it is a malignant pulmonary lesion. Solitary pulmonary nodules' diagnosis involves a careful review of patient history, patient's smoking history, history of any previous malignancy, travel history, history of exposure to carcinogens (occupational risk factors), and exploratory cancer diagnosis/treatment procedures such as bronchoscopy, thoracoscopy, needle aspiration biopsy. Cancer diagnostic scans such as chest radiographs (chest x-rats, chest CT scans, chest MRIs), Positron Emission Tomography (PET), and Single-Photon Emission Computed Tomography (SPECT) are often deemed necessary.

Solitary Pulmonary Nodule Treatment:

Treatment for solitary pulmonary nodule depends upon whether or not the lesions are malignant. Patients diagnosed to have benign solitary pulmonary nodules (benign lung nodules) are usually followed up for up to 2 years from the time of diagnosis on chest radiographs (x-rays, and/or CT scans). Patients diagnosed to have malignancy (malignant solitary pulmonary nodules or malignant lung nodules) undergo a surgical procedure (thoracotomy, or lobectomy) for treatment/removal of malignant pulmonary nodules/lesions, and are then closely monitored with a follow-up chest radiograph (x-rays or or CT scans) every 3 to 4 months during the first year from the time of diagnosis and every 6 months during the second year. On a case by case basis, several procedures including Biopsy, Bronchoscopy, Contralateral pneumonectomy, Needle aspirations, Percutaneous needle biopsy, Thoracoscopy , Thoracotomy and Video-Assisted Thoracoscopy Surgery (VATS) may also be considered. Patients diagnosed to have indeterminate pulmonary lesions are also monitored closely on periodic chest radiographs.

Solitary Pulmonary Nodule Prognosis:

Lung Nodule Prognosis largely depends on whether the pulmonary lesion is a benign or a malignant pulmonary nodule, as well as on the the stage of the lung cancer at the time it is detected. Well over 80% of the patients diagnosed with malignant solitary pulmonary lesions survive 5 years and beyond following resection of a solitary bronchogenic carcinoma -i.e surgical removal of a stage IA pulmonary lesion.

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