Der solitäre Lungenrundherd

Abstract

Solitary pulmonary nodules (SPN) are radiologically defined as intraparenchymal lung lesions not bigger then 3 cm. In general all pulmonary nodules should be considered malignant until proven otherwise. Primary peripheral lung cancer is the most common cause, at 40%. The probability that an SPN is malignant increases with patient age. Spiral chest CT is the ideal imaging to indicate the precise anatomical location and expose other pathological findings. Malignant SPN can also persist without change for over 2 years. Only complete histological examination can exclude malignance. Therefore every SPN should be resected in operable patients. The surgical risk of video-assisted pulmonary resection and diagnostic thoracotomy is low. For patients who are not operable, other diagnostic procedures such as transthoracic needle aspiration or positron emission tomography may be helpful.

Size of tumour as a risk factor for malignancy in patients with peripheral pulmonary nodules

“…The solitary pulmonary nodule is a single mass lesion of unclear etiology which is seen on X-rays as a well-marginated rounded opacity less than or equal to 3 cm in diameter, surrounded by normal lung parenchyma and unassociated with atelectasis or lymphadenopathy. 1,2 There are more than 80 nosological entities that present radiologically as peripheral rounded opacities. They can be benign lesions, primary bronchial carcinomas or pulmonary metastases.…”

“…They can be benign lesions, primary bronchial carcinomas or pulmonary metastases. [1][2][3] The newly found solitary pulmonary nodules have recently been found to increase in incidence. 2,4 According to literature estimates, 30% to 68% of these lesions are malignant.…”

“…[1][2][3] The newly found solitary pulmonary nodules have recently been found to increase in incidence. 2,4 According to literature estimates, 30% to 68% of these lesions are malignant. 2 Among these the bronchial carcinoma has the greatest incidence; the only therapeutic modality that is known currently to be effi cient in treating these tumours is immediate surgical resection.…”

“…2,4 According to literature estimates, 30% to 68% of these lesions are malignant. 2 Among these the bronchial carcinoma has the greatest incidence; the only therapeutic modality that is known currently to be effi cient in treating these tumours is immediate surgical resection. It is therefore important that a prompt and defi nitive histologic diagnosis be made.…”

“…It is therefore important that a prompt and defi nitive histologic diagnosis be made. 2,5,6 With the advent of such imaging techniques as HR-CT and PET in the last 20 years the diagnostic accuracy in this respect has been considerably improved without however solving defi nitively the problem with the histologic identifi cation of the solitary pulmonary nodules which still present a serious diagnostic and therapeutic challenge.…”