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Lung Nodule Clinic

Beautiful middle-aged woman looks forward wearing a head wrap

You may have been told that you have a nodule in your lung based on some imaging study. Commonly called a “spot on the lung” or a “shadow,” a nodule is a round area that is more dense than normal lung tissue. It shows up as a white spot on a CT scan. Lung nodules are usually caused by scar tissue, a healed infection that may never have made you sick, or some irritant in the air. Sometimes, a nodule can be an early lung cancer. Most patients with early cancers often have no respiratory symptoms. We understand how not knowing what the nodule represents can be stressful to anyone.
 

More Information About Lung Nodules

Lung nodules (also called pulmonary nodules) can be just a few millimeters in size. Your healthcare team can tell you the exact size of your nodule. Most nodules are less than 10 millimeters (about a ½ inch).  To help you get perspective on the size of your nodule, here are the sizes of some common items for comparison:

  • 1 mm: Pencil Tip
  • 2 mm: Crayon Tip
  • 5 mm: Pencil Eraser
  • 10 mm: Pea
  • 20 mm: Peanut

Nodules are often found as a spot on the lung during lung cancer screenings or other imaging studies that include the lungs. Pulmonary nodules are present in nearly half of all chest imaging scans, but only a small number end up being cancerous. Some nodules go away on repeat imaging, especially if they are due to a small infection or inflammation.  Other times, we continue to follow the nodule closely, looking for small changes in size. If concerning to the team, we sometimes recommend a biopsy to get more information as to the cause.

What causes nodules in the lungs?

Common causes of lung nodules include:

  • Infections: When infections cause inflammation in lung tissue, groups of cells may clump together forming granulomas. These bean-shaped growths are noncancerous.
  • Inflammation
  • Scarring
  • Cancer
     

The Lung Nodule Clinic at Trinity Health Michigan: Why Choose Us?

At our Lung Nodule Clinic, where trusted experts assess pulmonary nodules and give you personalized recommendations.

Highlights of our program include:

  • Highly-skilled lung doctors: You will receive care from lung experts from radiology, surgery and pulmonary medicine. This group of doctors discuss the more difficult lung nodule cases in a conference. We review the imaging of the nodule, discuss the possible causes, determine whether further testing or biopsy is warranted, arrange an appointment in the lung nodule clinic or pulmonary office to review and discuss next steps with the patient. 
     
  • Nurse navigator: With lung nodules, it's natural to have questions and we're happy to help. Our team includes a nurse who helps patients navigate the evaluation of an identified nodule. If you need additional tests, appointments, or have questions, the nurse navigator helps coordinate all aspects of your care.
     

Care Services for Lung Nodules

We use a variety of techniques to learn more about the nodules and what they mean for your health. We start by looking at the nodule on imaging scans. We also ask about your health history, including lung disease and whether you use or have used tobacco. We then perform a physical exam that includes listening to your lungs.

Your care may also include:

  • Advanced testing options: Interventional radiologists assess suspicious nodules using bronchoscopy. They slide a tiny camera down your nose or throat to evaluate nodules and take a tissue sample if necessary. These tests allow us to identify the early signs of aggressive cancers, such as small cell lung cancer.
  • Follow up chest imaging: Our experts may recommend repeat chest imaging if a nodule is less concerning or too small to be biopsied. The follow up imaging studies are to determine whether the nodule is growing. We will watch that nodule closely.
  • PET/CT: We may recommend more tests, such as PET/CT, to evaluate the nodule. This looks for activity in the nodule to provide more information on a cause and help us decide on next steps
  • Robotic bronchoscopy: Our lung doctors perform this procedure using a robotic arm with a catheter. It  extends  through the airway into the lung in the area of the nodule to obtain a biopsy. It uses GPS-like technology to get as close to the nodule as possible to  get a sample for testing.
  • Biopsy from the outside using a CT scan: Our team may  recommend a biopsy from the outside with a small needle to sample the nodule. These procedures are done by interventional radiologists. A CT scan is used at the time of biopsy to mark the target nodule and guide the needle
  • Surgical biopsy: Occasionally our chest surgeons recommend biopsy of the nodule surgically using a small camera and tools place through a small hole between the ribs.  This often allows for the nodule to be removed to help determine the cause

 

Again, our experienced surgeons, lung doctors, radiologists discuss difficult lung nodule cases together in our multidisciplinary lung nodule conference. The team reviews the images and recommend the next best step to get our patients answers. We work as a team so your care moves forward as quickly as possible. Find out more about lung cancer.