The solitary pulmonary nodule. Assessment, diagnosis, and management

We have presented a brief overview of an approach that has been very successful in our hands in the patient with an SPN. Even though the patient who has undergone a thoracotomy is full of gratitude to his physician when told that the resected lesion was benign and does not question the need for the thoracotomy, we have met equally happy and gratified patients when they were told that their lesion is benign be it after CT densitometry or needle biopsy. When properly performed, these techniques demand care and attention to detail much like the surgeon performing a delicate procedure. Without proper care, these procedures can in fact reflect negatively on the physician performing them and fall in disrepute. CT densitometry and transthoracic needle aspiration biopsy allow effective management of the patient with an SPN with prompt documentation of both malignant or benign lesions. With the proper application of these techniques, the majority of patients with benign disease will not need a thoracotomy for diagnosis with resultant benefits to the patient as well as to third-party payers.