Nonsolid and part-solid pulmonary nodules - 04/05/09

Introduction Nonsolid and part-solid pulmonary nodules have recently been described on CT scans.

State of knowledge Nonsolid and part-solid pulmonary nodules account for 2.9 to 19% of all pulmonary nodules detected in high-risk patients included in CT screening series for lung cancer. Radiologic-pathologic correlations showed that the aetiology could be of either benign origin (chronic pneumonia, atypical adenomatous hyperplasia, localized fibrosis) or of malignant origin (bronchioloalveolar carcinoma, adenocarcinoma, more rarely metastasis). Part-solid or nonsolid nodules are more likely to be malignant than solid ones. However, the doubling time of nonsolid nodules can be longer than part-solid ones and even longer than the doubling time of solid nodules. The prognosis of the patients is thus related to the percentage of subsolid component.

Prospects Management of these nodules requires prolonged surveillance of nodules less than 10mm in diameter and surgical excision of nodules greater than 10mm persisting on scans between 1 to 3 months after discovery and administration of anti-inflammatory and anti-infectious therapy.

Conclusion Nonsolid and part-solid pulmonary nodules at CT scanner warrant specific management.