Pulmonary Nodule
Respiratory (12%) Core Clinical Conditions
2B The Physician Associate is able to undertake the day to day management of the patient and condition once the diagnosis and strategic management decisions have been made by another.
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Definition Aetiology Pathophysiology Risk factor Sign and Symptoms Investigations Management
Definition
Pulmonary nodules are typically 3 cm (approximately 1 inch) or smaller areas of shadowing in the lung. They are visible on a body scan (CT scan) and occasionally on a chest-X-rays.
Aetiology
Common findings but generally speaking, individuals are asymptomatic.
Most are benign, might be caused by scarring from lung infection e.g tuberculosis (TB) or rheumatoid arthritis (RA).
Pathophysiology
Can be inflammatory of malignant nodules.
Inflammatory: can be caused by an infection or noninfectious inflammation.
Malignant: Non-Small Cell Lung Cancer (NSCLC) or Small Cell Lung Cancer (SCLC). These are generally caused by a genetic mutation which causes abnormal cell growth causing lung cancer.
Risk factors
Smoking.
Age: more common in over 40s.
Occupation: e.g mining, construction, asbestos handling.
Individual and/or family history of pulmonary nodules.
Immunocompromised.
Genetic factors.
Sign and symptoms
Shortness of Breath (Dyspnea).
Chest Pain.
Weight loss.
Unexplained weight loss.
Diagnosis and investigations
CT scan.
Chest X-ray.
PET-CT Scan.
Management
If asymptomatic regular monitoring.
If caused by infection e.g TB or a fungal infection, antibiotics or antifungal therapy will be commenced.
If suspicious of malignancy: biopsy + consideration of surgery.
If cancer is diagnosed: chemo/radiotherapy.
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