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What happens when a screening CT or a CT scan performed for another reason, shows a lung nodule? In pulmonary clinic, we see more and more lung nodules due to increased screening and general increased use of the CT scanner. A lot of my patients get cardiac CT studies focusing on the coronary arteries, but incidentally, are found to have nodules or spots that are detected in the lung as well. What do we do in these situations? A few areas I evaluate are the patient’s symptoms, their functional status, risk factors for the development of lung cancer, smoking history, and characteristics of the lung nodule itself on the CT scan. If the risk of lung cancer is deemed small, most physicians will simply opt to monitor the nodule serially over time with repeat CT scans, usually in six to 12 month intervals, demonstrating overall a two to five-year stability. After two to five years of stability, depending on the characteristics of the nodule, no additional imaging would be needed to be done as it’s assumed that the nodule is benign and not a malignant process.
