Department of Respiratory Medicine, Ipswich General Hospital, Brisbane, Queensland, Australia.
Discipline of Medicine, School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
Intern Med J. 2019 Mar;49(3):306-315. doi: 10.1111/imj.14219.
The solitary pulmonary nodule represents a common diagnostic challenge for clinicians. While most are benign, a significant number represent early, potentially curable lung cancers. With the increased utilisation of chest computed tomography, solitary pulmonary nodules are increasingly being identified and with lung cancer screening programmes now on the horizon globally, it is crucial clinicians are familiar with the evaluation and management of solitary pulmonary nodules. Through the evaluation of patient risk factors combined with computed tomography characteristics of solitary pulmonary nodules, including size, growth rate, margin characteristics, calcification, density and location; a clinician can assess the risk of malignancy. This article provides an up to date review of the imaging features of both benign and malignant solitary pulmonary nodules to assist in the identification of nodules that require histological confirmation or ongoing surveillance. In addition, we summarise the newly updated Fleischner Society Guidelines that provide clinicians with a framework for the evaluation and management of solitary pulmonary nodules.
孤立性肺结节是临床医生面临的常见诊断挑战。虽然大多数是良性的，但相当一部分代表着早期、潜在可治愈的肺癌。随着胸部计算机断层扫描的广泛应用，孤立性肺结节的检出率越来越高，而且全球范围内的肺癌筛查计划也在逐步推进，因此临床医生熟悉孤立性肺结节的评估和管理至关重要。通过评估患者的危险因素以及孤立性肺结节的 CT 特征，包括大小、生长速度、边缘特征、钙化、密度和位置；临床医生可以评估恶性肿瘤的风险。本文综述了良性和恶性孤立性肺结节的影像学特征，以帮助识别需要组织学证实或持续监测的结节。此外，我们总结了新更新的 Fleischner 学会指南，为临床医生提供了评估和管理孤立性肺结节的框架。
