Pulmonary nodule classification: Difference between revisions

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Latest revision as of 13:09, 2 July 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

Pulmonary nodule may be classified according to size (> 8 mm vs. ≤ 8 mm), attenuation (pure solid vs. part-solid), and distribution (solitary vs. multiple). It can also be classified into benign and malignant based on the radiological findings.

Classification

Based on size, attenuation, and distribution

Pulmonary nodule may be classified according to size, attenuation, and distribution into the following:^[1]

Size

Nodules measuring >8 mm and < 30 mm in diameter
Nodules measuring ≤8 mm in diameter

Attenuation

Pure solid nodules
Part-solid nodules

Distribution

Solitary pulmonary nodule
Multiple pulmonary nodules

Based on Radiological Findings

The table below summarizes the radiological features suggestive of benign or malignant pulmonary nodules.^[2]


Radiologic feature	Benign	Malignant
Radiologic Features Suggestive of Benign or Malignant Pulmonary Nodules Adapted from American Academy of Family Physicians ^[3]
Size	< 5 mm	> 10 mm
Border	Smooth	Irregular or spiculated
Density	Dense, solid	Nonsolid, “ground glass”
Calcification	Typically a benign feature, especially in “concentric,” “central,” “popcorn-like,” or “homogeneous” patterns	Typically noncalcified, or “eccentric” calcification
Doubling time	Less than one month; more than one year	One month to one year

References

↑ Ost D, Fein AM, Feinsilver SH (2003). "Clinical practice. The solitary pulmonary nodule". N. Engl. J. Med. 348 (25): 2535–42. doi:10.1056/NEJMcp012290. PMID 12815140. Unknown parameter |month= ignored (help)
↑ Albert RH, Russell JJ (2009). "Evaluation of the solitary pulmonary nodule". Am Fam Physician. 80 (8): 827–31. PMID 19835344.
↑ Solitary Pulmonary Nodule: Morphological Evaluation. http://pubs.rsna.org/doi/pdf/10.1148/radiographics.20.1.g00ja0343 Accessed on March 15, 2016

Template:WH Template:WS

[NEJM-cp-1] Ost D, Fein AM, Feinsilver SH (2003). "Clinical practice. The solitary pulmonary nodule". N. Engl. J. Med. 348 (25): 2535–42. doi:10.1056/NEJMcp012290. PMID 12815140. Unknown parameter |month= ignored (help)

[pmid19835344-2] Albert RH, Russell JJ (2009). "Evaluation of the solitary pulmonary nodule". Am Fam Physician. 80 (8): 827–31. PMID 19835344.

[CDC-3] Solitary Pulmonary Nodule: Morphological Evaluation. http://pubs.rsna.org/doi/pdf/10.1148/radiographics.20.1.g00ja0343 Accessed on March 15, 2016

[1]

[2]

[3]

@@ Line 4: / Line 4: @@
 ==Overview==
+Pulmonary nodule may be [[Classification|classified]] according to size (> 8 mm vs. ≤ 8 mm), [[attenuation]] (pure solid vs. part-solid), and distribution ([[solitary]] vs. multiple). It can also be [[Classification|classified]] into [[benign]] and [[malignant]] based on the [[radiological]] findings.
-According to the Fleischner Society, solitary pulmonary nodules may be classified by size, distribution, and attenuation, into 5 categories: solid nodules measuring >8 mm in diameter, solid nodules measuring ≤8 mm in diameter, pure subsolid nodules, part-solid nodules, and multiple nodules.
 ==Classification==
+===Based on size, attenuation, and distribution===
+Pulmonary nodule may be [[Classification|classified]] according to size, [[attenuation]], and distribution into the following:<ref name="NEJM-cp">{{cite journal |author=Ost D, Fein AM, Feinsilver SH |title=Clinical practice. The solitary pulmonary nodule |journal=N. Engl. J. Med. |volume=348 |issue=25 |pages=2535–42 |year=2003 |month=June |pmid=12815140 |doi=10.1056/NEJMcp012290 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=12815140&promo=ONFLNS19}}</ref>
-According to the Fleischner Society, solitary pulmonary nodules may be classified by size, distribution, and attenuation, into 5 categories:
+====Size====
+*Nodules measuring >8 mm and < 30 mm in [[diameter]]
+*Nodules measuring ≤8 mm in [[diameter]]
-*Solid nodules measuring >8 mm in diameter
+====Attenuation====
-*Solid nodules measuring ≤8 mm in diameter
+*Pure solid nodules
-*Pure subsolid nodules
 *Part-solid nodules
-*Multiple nodules
+====Distribution====
+*[[Solitary]] pulmonary nodule
+*Multiple pulmonary nodules
+===Based on Radiological Findings===
+The table below summarizes the [[radiological]] features suggestive of [[benign]] or [[malignant]] pulmonary nodules.<ref name="pmid19835344">{{cite journal |vauthors=Albert RH, Russell JJ |title=Evaluation of the solitary pulmonary nodule |journal=Am Fam Physician |volume=80 |issue=8 |pages=827–31 |year=2009 |pmid=19835344 |doi= |url=}}</ref>
+{|style="border: 5px; font-size: 90%; margin: 5px; width: 1000px" align=center
+!style="padding: 5px 5px; background: #4479BA; font-weight: bold; text-align:center;" colspan="3"|{{fontcolor|#FFF|''' Radiologic Features Suggestive of Benign or Malignant Pulmonary Nodules''' <br><SMALL> Adapted from American Academy of Family Physicians <ref name="CDC"> Solitary Pulmonary Nodule: Morphological Evaluation. http://pubs.rsna.org/doi/pdf/10.1148/radiographics.20.1.g00ja0343 Accessed on March 15, 2016 </ref></SMALL>}}
+|valign=top|
+|+
+|-
+! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|'''Radiologic feature'''}}
+! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|'''Benign'''}}
+! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|'''Malignant'''}}
+|-
+|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"| Size
+|style="padding: 5px 5px; background: #F5F5F5;"|
+* < 5 mm
+|style="padding: 5px 5px; background: #F5F5F5;"|
+* > 10 mm
+|-
+|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"| Border
+|style="padding: 5px 5px; background: #F5F5F5;"|
+* Smooth
+|style="padding: 5px 5px; background: #F5F5F5;"|
+* Irregular or spiculated
+|-
+|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"| Density
+|style="padding: 5px 5px; background: #F5F5F5;"|
+* Dense, solid
+|style="padding: 5px 5px; background: #F5F5F5;"|
+* Nonsolid, “ground glass”
+|-
+|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"| Calcification
+|style="padding: 5px 5px; background: #F5F5F5;"|
+* Typically a benign feature, especially in “concentric,” “central,” “popcorn-like,” or “homogeneous” patterns
+|style="padding: 5px 5px; background: #F5F5F5;"|
+* Typically noncalcified, or “eccentric” calcification
+|-
+|style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"| Doubling time
+|style="padding: 5px 5px; background: #F5F5F5;"|
+* Less than one month; more than one year
+|style="padding: 5px 5px; background: #F5F5F5;"|
+* One month to one year
+|}
 ==References==