Solitary pulmonary nodules: new wine in old bottles

Management strategies for solitary pulmonary nodules have evolved slowly during the last 50 years. The goal has always been to facilitate the resection of malignant nodules without undue delay and to avoid exploratory thoracotomy for benign nodules. In the past decade, the development of reliable nodule enhancement techniques has replaced or become incorporated within some of the older strategies. In addition, some of the well-accepted concepts of the past have been undergoing critical reviews and reevaluations. These concepts include retrospective study of nodule diameters to recognize 2-year stability, the use of a watch-and-wait strategy using standard chest radiographs for prospective determination of stability, detection and recognition of calcification patterns on standard chest radiographs, and computed tomography for mediastinal staging.