Approach to Solitary Pulmonary Nodule

When a solitary pulmonary nodule appears in the lungs, it represents a disruption or anomaly in the normal lung tissue. The most concerning etiology is malignancy, including primary lung cancers and metastatic cancer. Non-malignant causes include granulomas, inflammatory diseases, benign tumors, and other non-malignant conditions. Assessing the stability of the patient is the first step in the approach, followed by a thorough evaluation of symptoms, risk factors, and physical examination. Certain findings, such as age over 50, irregular borders, specific calcification patterns, and larger size, increase the likelihood of malignancy. The workup and management of a solitary pulmonary nodule depend on the size and risk of malignancy, with low-risk nodules requiring minimal follow-up and high-risk nodules demanding closer monitoring and potential tissue sampling.