Incidentally diagnosed pulmonary nodules: A diagnostic algorithm

Abstract

Asymptomatic solitary pulmonary nodules incidentally revealed by computed tomography constitute a serious medical problem. Depending on their diameter, solid, part-solid, or pure ground-glass pulmonary nodules may be observed, diagnosed radiologically/invasively, or treated surgically in accordance with international guidelines. Pure ground-glass nodules, semi-solid lesions, or solid lesions smaller than 8 mm should be monitored using low-dose computed tomography. In the case of solid nodules greater than 8 mm, assessing the risk of malignancy is recommended. Patients with pulmonary lesions at high risk of malignancy should undergo diagnostic investigation, or the nodule should be removed surgically. If the risk of lung cancer is low, the patients can continue to be monitored. Needle biopsy is one of the basic invasive methods of lung tumor diagnostics. Obtaining a cytological or histopathological diagnosis is helpful in making appropriate clinical decisions and can reduce the risk of unnecessary interventions, decreasing the rate of benign nodule resections and reducing the costs of medical treatment.