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What is a Lung Nodule? What does it mean when a spot appears on the lung?

 

On chest X-ray or tomography, nodules (spots) of less than 2-3 cm in size can be seen in the lung due to many causes. In many patients, these nodules may be caused by benign causes (infection, old scars) or may be the first stage of a malignant tumor. For this reason, it is very important to follow up nodules in the lung.

Akciğer Nodülü nedir?

In general, benign causes are much more common in young or non-smokers, whereas in middle-aged and older people, especially those who have smoked for a long time, these nodules are more likely to be malignant.

 

Is a lung nodule dangerous?

 

A lung nodule can be benign or malignant. It should not be forgotten that lung cancer also starts from a millimeter-sized nodule. Since it may be malignant, a lung nodule is a condition that should be taken into consideration seriously. In order to distinguish between benign and malignant, a follow-up algorithm is determined based on the size of the nodule and risk factors such as age and smoking. In some people, radiological follow-up is performed at intervals, while advanced examinations such as PET-CT or biopsy should be performed when a risky situation is observed.

Can a benign lung nodule transform into cancer?

 

A nodule in the lung is either benign or malignant. In fact, a benign nodule does not transform into cancer. However, some nodules that are actually cancerous can grow very slowly. For this reason, a nodule should be followed up for at least 2 years at regular intervals to see if it is growing. Nodules that do not grow or disappear during this period are accepted to be benign.

Akciğerde leke görülmesi ne anlama gelir?

What are the diagnostic methods for lung nodules?

 

Radiological images of nodules, especially on tomography, can also give an idea about whether they are benign or malignant. For nodules larger than 1 cm, the cancer screening-detection method called PET-CT is very useful in distinguishing whether the nodule is malignant or not. Depending on the patient’s age, whether the patient is a smoker or not, and the tomography and PET-CT images, these nodules are either followed up at regular intervals or, in appropriate nodules, a needle biopsy can be taken from the outside or, for a more definitive diagnosis, they can be completely removed by endoscopic (VATS) surgery.

Should a lung nodule be removed?

 

When a nodule is detected in the lung, it is first investigated whether it is benign or malignant. Those that are more likely to be malignant should be surgically removed. Because malignant tumors caught at this stage have a very high chance of cure if they are surgically removed. We know that it is possible to completely get rid of lung cancers caught at an early stage with surgical treatment. The patient group that we can be most beneficial in lung cancer is the patients who are caught at the small nodule stage.

her akciğer nodülü kanser midir?

Which surgical method is used in the treatment of lung nodules?

 

Lung nodules should be operated with a closed method called VATS or videothoracoscopy. With VATS surgery performed through a single hole, the patient’s nodule is removed in the same session, the nodule is differentiated between benign and malignant with rapid pathology, and if the result is understood to be malignant, the patient’s cancer surgery is completed by removing the lung lobe or segment in the same operation and additionally cleaning all lymph nodes in the chest cavity, again by closed method and through a single hole.

Lung Nodule Surgery

Lung nodules are small masses  in the lung tissue, usually visible on X-ray or CT scan. These nodules can be benign or malignant. Nodules are defined by their size, density, and shape. Smaller and smooth nodules are generally considered non-cancerous, while nodules with irregular borders, mixed density or those that grow over time are among those at risk of cancer.

Lung nodules are usually asymptomatic and are found by chance during random chest scans. The cancer risk of these nodules varies depending on their size.

 

Lung nodule surgery is performed using a endoscopic procedure known as VATS. The procedure involves the following steps:

General anesthesia: The patient is given general anesthesia for the operation, so that the patient is not conscious during the operation.

Surgical Access: An incision of about 3 cm is made in the chest area. Through this incision, a 1 cm diameter camera and surgical instruments are inserted into the inner side of the rib and into the lung.

Removal of the Nodule: Guided by the images obtained with the camera, the nodule in the lung is precisely removed.

Pathology Examination: The removed nodule is sent to the laboratory for pathology examination. Pathology results determine whether the nodule is cancerous or not.

Lobectomy: If the pathology results show lung cancer, an operation called a lobectomy is performed in the same session. A lobectomy involves removing part of the lung.

 

This way, lung nodule surgery is performed by VATS and patients recover in a short period of time.

Nodules smaller than 6 mm in diameter usually have a low cancer risk and are followed up.

Nodules between 6 mm and 10 mm are carefully evaluated.

Nodules larger than 10 mm have a high risk of cancer and may require biopsy or surgical intervention.

Nodules larger than 3 cm are called “lung masses” and require special evaluation.

 

Causes of lung nodules include a few factors such as infections, enlarged lymph nodes, scars, cysts and lung cancer. Therefore, a range of diagnostic tests and procedures are used to assess whether a lung nodule is cancerous.

 

If the nodule is at high risk of becoming cancerous or tends to grow, doctors may perform a biopsy. A biopsy helps to confirm or deny the presence of cancer by taking tissue samples from the nodule.

 

As a result, in the case of a lung nodule, the priority is to confirm the diagnosis and, if necessary, determine the appropriate treatment. Therefore, when a lung nodule is diagnosed, it is important to be carefully evaluated and followed up by a specialized healthcare team.

 

What Causes Lung Nodules?

 

Lung nodules can occur for different reasons. Here are some factors that can cause lung nodules:

 

Infections: Infections in the lungs, especially bacterial or fungal infections such as pneumonia or tuberculosis, can cause lung nodules.

 

Lymph Gland Enlargement: Enlarged lymph nodes in the lungs can cause nodules to form in these areas.

 

Fungal Infections: Fungal lung diseases can contribute to the development of nodules in the lungs.

 

Phlegm Accumulation: Phlegm or mucus that accumulates in the small airways can contribute to the formation of lung nodules.

 

Scars: Scars from previous lung surgeries or injuries can cause nodules to appear.

 

Cysts: Cysts or fluid-filled sacs in the lungs can lead to the formation of nodules.

 

Cancer: Unfortunately, sometimes lung cancer or metastatic cancers (cancers that have spread from other organs to the lung) can cause nodules to appear in the lungs.

 

Can lung nodules disappear on their own?

 

Benign lung nodules do not spread and are usually not life-threatening. Sometimes these nodules can be inflammatory in nature and may shrink or disappear by the time of your next scan.

 

Can you have more than one lung nodule?

 

Yes, you can have more than one lung nodule. Multiple nodules do not necessarily mean that your nodules are cancerous.

 

I have been diagnosed with lung nodules. What should I do?

 

Your doctor will create a plan for follow-up or further diagnostic tests, considering the size and appearance of the nodule and other features. These tests may include repeat CT scans, PET scans and biopsies.

Not all lung nodules are cancerous, and many nodules can be caused by benign (non-cancerous) causes. Therefore, it is important to follow the monitoring and diagnostic process, taking your doctor’s guidance into account. The cause of a lung nodule and potential treatment options may vary depending on the characteristics of the nodule and the patient’s medical condition.

Ask Prof. Dr.
Erdal Okur





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