Solitary pulmonary nodule corresponds to a common radiographic finding, which is
frequently detected incidentally. The investigation of this entity remains
complex, since characteristics of benign and malignant processes overlap in the
differential diagnosis. Currently, many strategies are available to evaluate
solitary pulmonary nodules with the main objective of characterizing benign
lesions as best as possible, while avoiding to expose patients to the risks
inherent to invasive methods, besides correctly detecting cases of lung cancer
so as the potential curative treatment is not delayed. This first part of the
study focuses on the epidemiology, the morfological evaluation and the methods
to determine the likelihood of cancer in cases of indeterminate solitary
pulmonary nodule.
A solitary pulmonary nodule is a common, often incidental, radiographic finding.
The investigation and differential diagnosis of solitary pulmonary nodules
remain complex, because there are overlaps between the characteristics of benign
and malignant processes. There are currently many strategies for evaluating
solitary pulmonary nodules. The main objective is to identify benign lesions, in
order to avoid exposing patients to the risks of invasive methods, and to detect
cases of lung cancer accurately, in order to avoid delaying potentially curative
treatment. The focus of this study was to review the evaluation of solitary
pulmonary nodules, to discuss the current role of
18F-fluorodeoxyglucose positron-emission tomography, addressing its
accuracy and cost-effectiveness, and to detail the current recommendations for
the examination in this scenario.
The fraction of lung volume receiving blood from the pulmonary artery is reduced in patients with COPD. The degree of underperfusion seems to correlate with the degree of airflow limitation.
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