Diagnostic approach to incidental pulmonary nodules: make it easy!

Congress:

ECR 2018

Poster Number:

C-1504

Type:

Educational Exhibit

Keywords:

Neoplasia, Education and training, Cancer, Structured reporting, Screening, Education, PET-CT, CT, Thorax, Oncology, Lung

Authors:

R. Silini, C. Fink; Celle/DE

DOI:

10.1594/ecr2018/C-1504

DOI-Link:

https://dx.doi.org/10.1594/ecr2018/C-1504

Fig. 1: Axial high-resolution CT images demonstrate groundglas with a size greater than...

Fig. 2: Axial high-resolution CT images showing a nodule with spiculated margins in a...

Fig. 3: Axial high-resolution CT und PET-CT images demonstrate a lymphoma- or...

Fig. 4: Axial high-resolution CT images demonstrate a calcified nodule of the right...

Learning objectives

The purpose of our educational exhibit is to: 1/ Describe different types of pulmonary nodule. 2/ Describe the conduct to adopt in the current practice.

Background

The detection of an incidental pulmonary nodule on chest CT is not an exceptional situation in the routine practice. The etiologies are varied, including mainly tumors, infections and inflammatory diseases. The most frequent malignant lesions are pulmonary metastases and primary bronchopulmonary cancers.

Findings and procedure details

There are three types of pulmonary nodules: solid, subsolid and groundglas. Depending on the type, size, multiplicity and the risk factors of the patient, the management decision differs referring to the Fleischner Guidelines Fig. 1. The sign of the corona radiata or spiculated margins is very evocative of malignancy Fig. 2. It is important to detect an obstruction of lung vessels and bronchi, which is highly suggestive of malignancy; however some rare tumors, like lymphoma, may respect vessels Fig. 3. Other aspects of the nodule,...

Conclusion

The discovery of a pulmonary nodule is a frequent situation. By studying several aspects and referring to the Fleischner Guidelines we could optimize the management of pulmonary nodules.

Personal information

Prof. Dr. Christian Fink: Head of the Department of Radiology, Allgemeines Krankenhaus, 29223 Celle, Lower Saxony, Germany. Email:[email protected] Dr. Rached Silini: Resident in training, Department of Radiology, Allgemeines Krankenhaus, 29223 Celle, Lower Saxony, Germany. Email: [email protected]

References

Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017by MacMahon et al.Radiology (2017) DOI10.1148/radiol.2017161659. [Epub ahead of print] Guidelines for management of small pulmonary nodules detected on CT scans: a statement from the Fleischner Societyby MacMahon et al.Radiology (2005) 237:395-400 Recommendations for the management of subsolid pulmonary nodules detected at CT: a statement from the Fleischner Society.by Naidich DP. et al.Radiology (2013) 266(1):304-17. CT screening for lung cancer: frequency and significance of part-solid and nonsolid nodules.by Claudia I....