Pulmonary (Lung) Nodules

This leaflet provides information for those patients diagnosed with a pulmonary nodule.

What is a pulmonary nodule?

A pulmonary nodule is a small, round or oval-shaped growth in the lung. A pulmonary nodule is generally smaller than one centimetre and can be solitary (just one nodule) or multiple (several nodules). Pulmonary nodules are very common and often found incidentally on a chest X ray or CT scan when patients have these tests for other medical reasons.

Does a pulmonary nodule mean I have lung cancer?

Most pulmonary nodules, around 90%, are not cancerous (benign). However, some nodules may be early cancers. The likelihood of a nodule being or becoming cancerous depends on several risk factors and whether the nodule grows over time. People who smoke or have smoked, who have worked with asbestos or who have other types of cancers are at higher risk of getting lung cancer.

What causes pulmonary nodules?

There are two main types of pulmonary nodules: benign (non-cancerous) and malignant (cancerous).

Benign pulmonary nodules are the most common and can be caused by lung infections, such as pneumonia, or inflammation. These nodules usually do not grow and can resolve over time.

Malignant pulmonary nodules are caused by a lung cancer or a cancer that has spread from another part of the body. These nodules usually grow and enlarge over time.

What happens next?

Pulmonary nodules are monitored over time (surveillance) by chest CT scans to see if they grow.

Patients will be offered a telephone or in-clinic appointment to explain about the lung nodule and will then attend for a chest CT scan after several months (three to six months).The specialists decide the timing of the second scan after reviewing your CT scan and risk factors for having a cancerous nodule. Several CT scans may be performed over 1-4 years, depending on the specialist’s recommendations.

What other tests may be performed?

Breathing tests (lung function tests) and blood tests may be performed.

Another type of scan, a positron emission tomography scan (PET scan) may be required to look at the pulmonary nodule in more detail.

Usually the pulmonary nodules are too small to take a tissue sample from (biopsy) but sometimes a biopsy may be required. This is done via CT guidance (a CT guided lung biopsy) and may be discussed with you if relevant.

What if my doctor thinks the nodule is benign?

If the nodule does not grow over a specified time (usually one to two years) it is considered to be benign.

These nodules do not usually require treatment. If an active infection is found or another lung condition diagnosed some specific treatments may be started.

What if my doctor thinks the nodule is malignant or growing?

For nodules that grow over time other tests such as a PET scan or a CT guided biopsy may be required to find out if the nodule is a cancer.

What can I do?

Attendance for chest CT scans and follow up appointments is essential, even if you do not have any symptoms. Cancerous nodules detected early are more likely to be curable.

It is important that if you develop new or worsening symptoms associated with lung cancer, such as a cough, coughing up blood, shortness of breath, chest or shoulder pain, in between appointments that you report these to your doctor.

However long you have been smoking, it is always worth giving it up. This is a time to seriously consider quitting smoking. It can be hard, but free services and treatments are available to help and these have been shown to improve the chances of quitting successfully.

Where can I get more information?

This can be a worrying time for you and your loved ones but it is important to remember that most pulmonary nodules are benign.

Your doctor or respiratory clinical nurse specialist should be able to answer specific questions regarding your follow up.

Lung cancer specialist nurses:

Telephone 01223 217541 (voicemail available – non urgent messages will be responded to within 48hrs)

Smoking cessation support

For information and support on stopping smoking, call the free Smokefree National Helpline on 0300 123 1044 or visit the website:

NHS - Help to Quit Smoking (opens in a new tab) .

Cambridgeshire and Peterborough local stop smoking service – Healthy You

Healthy You (opens in a new tab)

Telephone: 0333 005 0093

Text: Healthyu to 60777

British Lung Foundation

British Lung Foundation (opens in a new tab)