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Lung NoduleAka: Pulmonary Nodule, Lung Mass

Background
1. Obtain CT Chest to further evaluate lung mass identified on Chest XRay
2. Evaluation below is based on the CT Chest
Evaluation: Nodule >1 cm
1. Discuss with pulmonology, thoracic surgery or radiology for work-up
2. Lung biopsy
3. Consider starting preoperative evaluation while awaiting biopsy
  1. Pulmonary Function Tests
  2. Electrocardiogram and other cardiac testing as needed
  3. Optimize comorbid conditions
Evaluation: Nodule <1 cm
1. Nodule 8-10 mm
  1. All patients: Repeat CT chest in 3, 9 and 24 months
2. Nodule 6-8 mm
  1. Low risk patient: Repeat CT chest in 6-12 months and 18-24 months
  2. High risk patient: Repeat CT chest in 3-6 months, 9-12 months and 24 months
3. Nodule 4-6 mm
  1. Low risk patient: Repeat CT chest in 12 months
  2. High risk patient: Repeat CT chest in 6-12 months and 18-24 months
4. Nodule <4 mm
  1. Low risk patient: No follow-up needed
  2. High risk patient: Repeat CT chest in 12 months
References
1. Gould (2007) Chest 132(suppl 3):108S
2. MacMahon (2005) Radiology 237(2):395

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This page was written by Scott Moses, MD. This page was last revised on 4/6/2009 8:02:26 AM. This page was last published on 8/14/2009. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.