Work-up of the solitary pulmonary nodule

Although the solitary pulmonary nodule (SPN) is a common presentation of lung cancer, most SPNs are benign. The challenge in evaluating SPNs is to avoid invasive procedures in patients who have benign nodules, without allowing potentially curable bronchogenic carcinomas the time to progress to more advanced or even unresectable disease. Various approaches include assessment of nodule morphology, interval growth and contrast enhancement, as well as techniques such as percutaneous biopsy, positron emission tomography scanning and depreotide imaging. The role of each of these approaches is discussed.