Paśnik Marcin, Bestry Iwona, Roszkowski-Śliż Kazimierz
Instytut Gruźlicy i Chorób Płuc, Płocka 26, 01-138 Warszawa, Poland.
Adv Respir Med. 2017;85(6):345-351. doi: 10.5603/ARM.2017.0059.
A solitary pulmonary nodule is a round opacity less than 30 mm in diameter surrounded by normally aerated lung tissue. Determination of the character of the lesion following its detection (particularly when the identification was incidental) may require a complex diagnostic process. In most cases, nodules are benign in character; however, the probability of malignancy increases significantly for part-solid lesions. The main features that describe the solitary pulmonary nodule in computed tomography scans include their size, shape, density, presence of calcification and rate of growth. PET-CT examination provides additional information on the metabolic activity of the lesions, and MRI is helpful in assessment of local invasion of surrounding structures. Due to limited availability and highly specialized character, these examinations are not routinely used. Therefore, despite development of other imaging modalities, computed tomography remains the most important and crucial diagnostic tool. Clinical risk factors such as age or smoking status are very important for evaluation of the likelihood of malignancy of a nodular lesion. Due to the multidisciplinary nature of data required for complex assessment of a solitary nodular lesion, management routines are needed in the diagnostic process such as those proposed by the Fleischner Society.
孤立性肺结节是指直径小于30mm的圆形致密影，周围为正常充气的肺组织。在发现病变（尤其是偶然发现）后确定其性质可能需要复杂的诊断过程。在大多数情况下，结节为良性；然而，部分实性病变的恶性概率会显著增加。计算机断层扫描中描述孤立性肺结节的主要特征包括其大小、形状、密度、钙化情况和生长速度。正电子发射断层显像-计算机断层扫描（PET-CT）检查可提供有关病变代谢活性的额外信息，磁共振成像（MRI）有助于评估周围结构的局部侵犯情况。由于可用性有限且专业性强，这些检查并非常规使用。因此，尽管有其他成像方式的发展，计算机断层扫描仍然是最重要和关键的诊断工具。年龄或吸烟状况等临床风险因素对于评估结节性病变恶性的可能性非常重要。由于对孤立性结节性病变进行复杂评估所需数据具有多学科性质，在诊断过程中需要管理流程，如弗莱施纳学会提出的那些流程。
