What is an incidental pulmonary nodule?
Finding a lung nodule on a chest X-ray or CT scan is common. A ‘lung nodule’ is a small, more dense area of the lung. You may also hear it being called a pulmonary nodule, a shadow, a lesion or a spot.
The spot is usually really small – like the size of a grain of rice or a smartie. If the spot is bigger than a ping pong ball, it’s given a different name: a lung mass.
Most of the time, nodules don’t affect lungs working or interfere with breathing.
Your doctor or specialist nurse may show you your scan to help you understand what we are looking at. On a lung CT image, the lungs look black, and the lung nodule shows up as a white spot within the lung.
The nodule can be due to lots of different causes.
These can include:
- a small area of infection (old or new)
- scarring
- normal glands within the lung (like lymph nodes)
- inflammatory lung diseases (sarcoidosis or rheumatoid arthritis)
- previous tuberculosis (TB)
In a small number of cases, they can be the first signs of an early cancer in the lung. If this is the case, finding them early makes them much more treatable.
Over 90% of nodules are benign (not cancer). The smaller the nodule, the less likely it is to be cancer.
How are they discovered?
About 1 in every 3 people who have a lung CT scan will have a nodule found. Many people have lung nodules without knowing it and are only discovered when a scan is performed for another reason.
Think of lung nodules like freckles or moles on your skin. Lots of people have them, and most of the time, they’re totally harmless. But just like how we keep an eye on freckles to make sure they don’t change; we like to watch lung nodules too – just in case they grow or change, or new ones show up.
And if you have more than one nodule, it doesn’t always mean it’s worse – it’s still usually okay, but we will keep an eye on them just to be safe.
How are they managed?
Sometimes, when doctors see a lung nodule on your scan, they can’t tell right away exactly what it is. When that happens, they might ask you to come back for more scans later – just to keep an eye on it.
This is called nodule surveillance or active monitoring. It means they’re watching the spot over time to see if it changes. You might need scans for up to 2 or 5 years, depending on the spot and your health.
Most nodules don’t change at all – they stay the same, get smaller, or even disappear! If it doesn’t grow after several scans, you probably won’t need any more check-ups for it.
Even if the nodule is something serious (like cancer), it usually grows very slowly – over many months or even years. So, watching it closely with scans is very safe, and it won’t affect your treatment or your chances of getting better.
It’s a good idea to try and go to the same place for your scans each time. That way, the pictures are easier to compare. Remember to keep track of your scan dates and appointments so you don’t miss them.
What is offered at MQRS?
At MQRS we provide a specialised pulmonary nodule service for patients found to have an incidental lung nodule. Patients need to be referred by their GP or specialist. A specialised clinical nurse consultant will review the referral, call the patients and triage the referral in collaboration with the respiratory physician. You will receive the specialised nurse consultants’ number should you need to speak with them further.
Those patients who may be at higher risk of the nodule being suspicious will be fast tracked in to see the physician. Patients with a lower risk nodule may not need to see the physician for a few months or until another CT scan is performed to be able to compare how the nodule looks. This will be discussed with you at the time of booking your appointment. If further imaging is required prior to the consult, this will also be arranged.
If further testing or investigations are required, they will be arranged swiftly through Macquarie University Hospital facilities. Please be aware that Macquarie University Hospital is a private hospital. Any fees or out of pocket costs will be discussed with you before any procedure or inpatient stay. If you don’t have private health insurance, many of our doctors also work at a public facility and may be able to care for you there.
Nodule Hotline
There is a GP ‘hotline’ for any queries regarding patient nodule referrals. They can be reached Monday to Friday 7am to 3pm.
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Our growing team of seasoned respiratory physicians and support staff provide expertise covering a wide range of pulmonary pathologies in state of the art investigational facilities operating out of Macquarie University Clinic and Hospital.