THE SOLITARY PULMONARY NODULE - UPDATE 1995

PURPOSE: This study analyzed the clinical characteristics, diagnostic evaluation, prevalence of malignancy, and outcome of patients with a s olitary pulmonary nodule (SPN) encountered in the outpatient practice of a pulmonologist in an urban university hospital from 1990 to 1993. PATIENTS AND METHODS: SPN was defined as a round or ovoid density less than or equal to 3 cm in diameter within the lung parenchyma. Patient s with and without lung cancer in SPNs were compared. RESULTS: Forty p atients had a mean age of 65 years, an almost equal sex distribution, high prevalences of cardiovascular disease (53%) and chronic obstructi ve pulmonary disease (COPD) (33%), but a low incidence of tuberculosis . The mean size of SPNs was 1.8 cm. The prevalence of malignancy was 5 3%. In SPNs less than or equal to 2 cm in diameter, the prevalence of malignancy was 43%. Nonsurgical biopsy techniques made a diagnosis in 78% of patients. In 94% of patients with lung cancer in SPNs, the tumo r was resectable (stage 1, 2, or 3A), emphasizing the need for early d etection. Despite the small size of the SPNs, the prevalence of malign ancy was high. CONCLUSION: Despite the advanced age and high prevalenc e of cardiovascular disease and COPD in patients with SPNs, lung cance r that occurs in these lesions appears to have a favorable prognosis i f detected promptly.