Management of Solitary Pulmonary Nodules

The workup and management of the solitary pulmonary nodule is an increasingly common and confounding clinical problem for which a uniformly accepted approach has yet to be established. Conventional radiologic literature has suggested a number of imaging characteristics of nodules such as size, cavitation, growth rate, and margin morphology to guide the physician in clinical management. More recent literature emphasizes nodule attenuation, as well as size, growth, etc., in correlation with patient risk factors for disease to guide the most appropriate course of follow-up. Risk factors include age greater than 35 years, smoking history, occupational exposures, and history of malignancy. In this chapter, based on a review of the established recommendations and the authors’ clinical experiences, an approach to the management of the solitary pulmonary nodule is put forth.