What is a lung nodule?
A lung nodule is an area of roundish shadowing or ‘spot’ usually 3 cm (approximately 1 inch) or smaller, in the lung. It can be seen on a CT scan (computed tomography) and sometimes on a chest X ray. This doesn’t usually cause any symptoms and is often found by chance.

Why do lung nodules occur?
Lung nodules are very common. Approximately 1 in 4 (25%) of older people who smoke or who are ex-smokers have nodules on a CT scan. About 1 in 10 (10%) of people who have never smoked may also have nodules. Most nodules are benign (non-cancerous) and may be caused by scarring from previous lung infections.

They are very common in people who have had TB (tuberculosis), and can occur in people who have had other conditions such as rheumatoid arthritis

Are lung nodules cancerous?
Most nodules are benign (non-cancerous). In a small number of people the nodule could be a very early lung cancer or occasionally a secondary cancer that has spread from elsewhere in the body.

Diagnosing lung nodules
Nodules are sometimes found on a chest X ray but in most cases they are too small and are only seen when the person has a CT scan. Lung nodules are often found when the person is having a CT scan for another reason. It is not always possible to know what the cause of a nodule is from the CT scan alone. As nodules are small, a biopsy (a test performed to take a sample of the nodule) may be very difficult and risky. Instead, we often keep an eye on the nodule by repeating the CT scan after a certain amount of time to see whether it grows.

Benign (non-cancerous) nodules grow very slowly, or may not grow at all. On the other hand, malignant (cancerous) nodules will eventually grow, though this can also happen slowly. We can check if the nodule is changing by repeating a chest X ray or CT scan over a period of months or years.

As nodules can change very slowly there is no reason for doing chest X rays or CT scans any sooner. If the nodule grows or changes in any way then your lung specialist may arrange for you to have further tests.

What happens next?
Your CT scan will be reviewed by the lung specialist team. Depending on the advice, your CT scan will be repeated usually between three and 12 months. It may be necessary to have a number of CT scans over a number of years. This will depend on many factors including:

*whether you have other symptoms

*whether you have other known cancers

*whether you smoke or used to smoke

*your general health

*your other medical problems (including a history of previous cancer)

*your own wishes regarding further investigation

If the nodule stays the same we will be able to discharge you.

If the nodule grows or changes then your lung specialist may need to arrange for you to have further tests which may include a different kind of CT scan (called a PET-CT) or possibly a biopsy.

How will I get my results?
After your CT scan you will be informed of the results and the next steps by letter. On some occasions this may be done at an outpatient appointment.

Further Information
Your GP will be kept fully informed about your progress. You can contact your GP for any information or if you have any questions.

If you have any further questions you can contact our specialist nurses on 01935 384574 (9am to 5pm, Monday to Friday). Please leave a message on the answer phone and they will call you back.

Ref: 22/20/40
Review: 11/22