Abstract
The number of solitary pulmonary nodules (SPNs) detected each year is expected to
increase dramatically with the implementation of lung cancer screening. Although some
will have radiographic features highly specific for benignity, the rest are considered
indeterminate and require further investigation. The management options include continued
surveillance or immediate diagnostic sampling. The decision to proceed with immediate
sampling is determined by nodule characteristics (i.e., density and size), and patient
risk factors and preferences. Sampling is achieved either by surgical or by nonsurgical
techniques, and the choice between the two is influenced by the probability of malignancy.
Surgical methods are preferred in SPNs with high probability of malignancy because
they provide both a definitive diagnosis and treatment in a single procedure. In contrast,
when the probability of malignancy is low to moderate nonsurgical sampling is preferred.
The following is a review of the diagnostic management options available when approaching
an SPN.
Keywords
nonsurgical - surgical - guided-bronchoscopy - thoracoscopy - solitary pulmonary nodule
- transthoracic needle biopsy
