differential of a single pulmonary nodule

Solitary pulmonary nodule (SPN) is defined as a relatively well defined round or oval pulmonary parenchymal lesion equal to or smaller than 30 mm in diameter. It is surrounded by pulmonary parenchyma and/or visceral pleura and is not associated with lymphadenopathy, atelectasis, or pneumonia .

Questions to ask when you want to approach a solitary pulmonary nodule :

• is the lesion solitary?
• is it intrapulmonary?
• is the lesion a nodule?
  • should be a discrete round/oval opacity 4-30 mm in diameter; a lesion >30 mm is defined as a mass, not a nodule
  • should not be linear or angular

Differential diagnosis

There are many causes of solitary pulmonary nodules, including:

• neoplastic
  • malignant
    • bronchogenic carcinoma
    • solitary pulmonary metastasis
    • lymphoma
    • carcinoid tumors
      • bronchial carcinoid tumor
      • peripheral pulmonary carcinoid tumor
  • benign
    • pulmonary hamartoma
    • pulmonary chondroma
    • primary pulmonary meningioma - rare
• inflammatory
  • granuloma
  • lung abscess
  • rheumatoid nodule
  • pulmonary inflammatory pseudotumor: plasma cell granuloma
  • small focus of pneumonia: round pneumonia
• congenital
  • arteriovenous malformation
  • lung cyst
  • bronchial atresia with mucoid impaction
• miscellaneous
  • pulmonary infarct
  • intrapulmonary lymph node
  • mucoid impaction
  • pulmonary hematoma
  • pulmonary amyloidosis
  • normal confluence of pulmonary veins

Mimics

• nipple shadow
• cutaneous lesion (e.g. wart, mole)
• rib fracture or other bone lesion
• vanishing pseudotumor of congestive heart failure
• summation of markings
• artifact

See also

• pulmonary nodules
• coin lesion
• Fleischner society criteria for incidental pulmonary nodules

Siehe auch:

• Arteriovenöse Malformation
• Lungenkarzinom
• Lymphom
• Lungenrundherd
• Lungenabszess
• Karzinoid
• Lungenzysten
• pulmonales Hamartom
• Lungenmetastasen
• Rundpneumonie
• Lungeninfarkt
• Bronchialatresie
• entzündlicher Pseudotumor der Lunge
• Empfehlungen Fleischner Society Lungenrundherd
• peripheral pulmonary carcinoid tumour
• Stefan Diederich pulmonaler Rundherd
• bronchiales Karzinoid
• pulmonales Granulom
• Pneumozytom
• pseudotumour

und weiter:

• arteriovenöse Malformationen der Lunge
• In Situ Adenokarzinom der Lunge
• multiple kleine hyperdense Lungenherde
• Plattenepithelkarzinom der Lunge
• nodular opacification
• pulmonary pseudotumour
• pulmonary manifestations of granulomatosis with polyangitis
• nipple
• Lungenläsionen mit Fett
• vanishing pseudotumour of congestive cardiac failure
• nipple in chest X-ray
• notch sign
• Granulomatose mit Polyangiitis Manifestationen in der Lunge
• cryptococcal granuloma