Solitary Lung Mass on X ray:workup in Davidsons - prayforthebest

[ArchivalUser]

1.get a previous X ray
(a)If previous X ray is available-size no change-observation
(b)If size has increased, no X ray available next step is
2.CT-because it gives better resolution
Assess the risk of the patient based on age, history of smoking, X ray, CT findings
3.risk assessment
Very high risk-60 year old man who smokes 30 cigarretes per day with a lesion which is spiculated and no calcification----best is to go for surgical resection directly.

Infection in the Ddx-Treat with antibiotics and follow with X ray to see there is resolution.

Others-depends on the case-Can do biopsy etc but answer is not clear cut. Dont have to worry about it so much?(not written in Davidsons)
Peripheral lesion-CT guided biopsy?
Central lesion-bronchoscopy?

Do share your thoughts.

[ArchivalUser]

Post by ben which was verified by triplehelix

This is what I got from the info, let me know what u think

A. 37 y/o non smoker w/ central solitary Lung nodule (or Peripheral Solitary Lung Nodule) found on CXR
--If Old X ray --See if any changes w/in past 12 mo
-If no X ray available --> Follow up w/ CXR every 3 mo for 1 year, if no changes leave it

B. 41 y/o Smoker smoker w/ central solitary Lung nodule (or Peripheral Solitary Lung Nodule) found on CXR
-Old Xray, if Old X ray not available CT next , if peripheral lesion FNA next (if Central Bronchosocpy next), if lesion is missed on CT then Open lung Biopsy

[ArchivalUser]

THe part that does not concur is if the X ray is not available, triple helix said CT is not needed. Could you please explain?

[ArchivalUser]

yes if CXR not available in the 1st Cases then follow the Pt w/ CXR every 3 months to for 1 year to oberve for any changes in nodule, if CXR stays the same then nothing needs to be done here (just leave it alone)

In the 2nd case if an Old CXR is not available then do a CT Scan next (b/c here Pt is at higher risk)