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 9.
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
There are many causes of solitary pulmonary nodules, including:
- nipple shadow
- cutaneous lesion (e.g. wart, mole)
- rib fracture or other bone lesion
- vanishing pseudotumor of congestive heart failure
- summation of markings
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