Solitary Pulmonary Nodule - Causes

Causes

Not every round spot on a radiological image is a coin lesion: it should not be confused with the projection of a structure of the chest wall or skin, such as a nipple, a healing rib fracture or electrocardiographic monitoring.

The most important cause to exclude is a form of lung cancer, including rare forms such as primary pulmonary lymphoma, carcinoid tumor and a solitary metastasis to the lung (common unrecognised primary tumor sites are melanomas, sarcomas or testicular cancer). Benign tumors in the lung include hamartomas and chondromas.

The most common benign coin lesion is a granuloma (inflammatory nodule), for example due to tuberculosis or a fungal infection. Other infectious causes include a pulmonary abscess, pneumonia (including Pneumocystis carinii pneumonia) or rarely nocardial infection or worm infection (such as dirofilariasis or dog heartworm infestation). Lung nodules can also occur in immune disorders such as rheumatoid arthritis or Wegener's granulomatosis.

An SPN can be found to be an arteriovenous malformation, a hematoma or an infarction zone. It may also be caused by bronchial atresia, sequestration, an inhaled foreign body or pleural plaque.

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