Krochmal Rebecca, Arias Sixto, Yarmus Lonny, Feller-Kopman David, Lee Hans
Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, 110 South Paca Street, Second Floor, Baltimore, MD 21201, USA.
Expert Rev Respir Med. 2014 Dec;8(6):677-91. doi: 10.1586/17476348.2014.948855. Epub 2014 Aug 23.
There are an increased number of pulmonary nodules discovered on CT scan images in part due to those performed for lung cancer screening. Risk stratification and patient involvement is critical in determining management ranging from interval imaging to invasive biopsy or surgery. A definitive diagnosis requires tissue biopsy. The choice of a particular biopsy technique depends on the risks/benefits of the procedure, the diagnostic yield and local expertise. This review will focus on the evaluation and management of pulmonary nodules based on the Fleischner Society and American College of Chest Physician guidelines. There have been recent changes to both societies' recommendations for incidental detection of solid and subsolid nodules, risk stratification, imaging, minimally invasive diagnostic techniques and definitive surgical options.
CT扫描图像上发现的肺结节数量有所增加，部分原因是为肺癌筛查而进行的扫描。风险分层和患者参与对于确定从定期成像到侵入性活检或手术的治疗方案至关重要。明确诊断需要组织活检。特定活检技术的选择取决于该操作的风险/益处、诊断率和当地的专业水平。本综述将基于弗莱施纳学会和美国胸科医师学会的指南，重点关注肺结节的评估和管理。最近，这两个学会关于实性和亚实性结节的偶然发现、风险分层、成像、微创诊断技术和确定性手术选择的建议都有所变化。
