[Subcentimeter pulmonary nodule: diagnostic and therapeutic problems]

In the majority of the cases it is difficult to evaluate the type of the subcentimeter pulmonary nodule basing on the clinical picture (age of the patient, cigarette smoking history, history of antecedent cancer) and radiographic diagnostics (CT HRCT PET). Usually it is possible only to estimate the probability of malignancy of lesions less than 1 cm. Transthoracic needle aspiration and bronchoscopy have been shown to provide no measurable preoperative benefit to the patient. The high-likelihood nodules should be excised if feasible and the low-likelihood lesions should be followed with serial CTs. Any substantial changes in shape, density and volumetric growth are indication for resection of the nodule. In those patients in whom these lesions are followed and found to represent cancer on subsequent CTs and work-up, there does not seem to be a worsened survival. In the selected cases of subcentimeter lung cancer based on tumor location, its radiographic and histological characteristics the intentional sublobar, parenchyma sublobar resection is the appropriate treatment.