Abstract
In the attempt to separate primary lung cancers and benign lesions presenting as solitary pulmonary nodules (SPNs) the authors studied prospectively 52 SPNs less than 30 mm in diameter by means of high-resolution (HRCT). Patients with known cancer were excluded. Margins, internal structure, bronchus sign, calcifications, pleural tag and gross morphology of SPN were considered. Spiculation, air inside the nodule and bronchus sign were found in cancer and in one benign lesion (spiculation). All other benign SPNs presented smooth margins without bronchus sign or air inside the mass. Final diagnosis was obtained with surgery, fine-needle-aspiration biopsy or 12-month follow-up. Of 52 nodules, 28 proved malignant, and 24 of 52 proved benign. Sensitivity and specificity of HRCT for diagnosing malignancy of the nodule were 100% and 96%, respectively. In conclusion, we think that HRCT is useful in the differentiation of cancers from benign lesions presenting as SPNs in the majority of patients without known neoplasm.
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