Pulmonary Nodules: Patient Information Sheet

1) What is a pulmonary nodule?

A pulmonary nodule is a small, round or oval spot in the lung seen on a chest X-ray or CT scan.
Pulmonary nodules are common and are often found by chance when a scan is done for another reason. Most nodules are benign (not cancer), especially in people under 40 and those who have never smoked.

2) Causes & risk factors

Pulmonary nodules can be caused by:

• Previous infections or inflammation
• Scar tissue in the lungs
• Benign growths
• Lung cancer (less common)

Risk factors that increase concern include:

• Smoking history
• Older age
• Family history of lung cancer
• Larger or growing nodules
• Certain occupational exposures (e.g. asbestos)

3) Symptoms & how it may present

Most pulmonary nodules do not cause symptoms and are found incidentally.
Rarely, if a nodule is large or related to infection, symptoms may include:

• Cough
• Chest discomfort
• Shortness of breath

Symptoms vary depending on the cause.

4) How is it diagnosed?

Pulmonary nodules are usually found on:

• Chest X-ray
• CT scan of the chest

People who are at a higher risk of developing lung cancer due to their risk factors may be eligible to enrol in the Australian National Lung Cancer Screening Program (NLCSP) which aims to detect lung nodules and cancers in early stages before people develop symptoms. The program involves performing low-dose CT chest scans to detect abnormalities.

Further assessment may include:

• Repeat CT scans over time to monitor size
• PET scan in selected cases
• Bronchoscopy or biopsy if cancer is suspected
• Referral to a respiratory or lung specialist

5) Treatment & management options

Management depends on the size, appearance, and risk factors:

• Many nodules are small and require no follow up
• Observation and follow up scans are often performed for larger nodules or for people with risk factors for cancer
• Antibiotics can be prescribed if infection is suspected
• Biopsy or surgical removal can be performed if cancer cannot be ruled out

6) Living with / managing pulmonary nodules

Most people live normally with pulmonary nodules.
Regular monitoring is important to ensure the nodule does not change over time. Your doctor will create a follow-up plan tailored to your risk level.

7) Prevention & risk reduction

• Stop smoking if you smoke
• Avoid second-hand smoke
• Use protective equipment if exposed to workplace hazards
• Attend recommended follow-up scans

8) When to seek medical advice

Contact your doctor if you develop:

• New or worsening cough
• Coughing up blood
• Unexplained weight loss
• Increasing breathlessness or chest pain