[The pulmonary nodule: from incidental finding to pathological confirmation]

Area of Science:

• Pulmonology
• Radiology
• Oncology

Background:

• Increasing use of lung CT scans leads to more incidental pulmonary nodules.
• While most nodules are benign, malignancy risk increases with specific features and patient history.
• Accurate diagnosis of incidental pulmonary nodules is crucial to manage malignancy risk.

Purpose of the Study:

• To outline an approach for the pathological diagnosis of incidental pulmonary nodules.
• To emphasize the importance of risk assessment for malignancy in incidental lung nodules.
• To discuss the factors influencing the decision for histologic confirmation.

Main Methods:

• Review of characteristics and behavior of malignant lung nodules.
• Integration of patient history, clinical, and imaging risk assessment.
• Consideration of patient comorbidities, preferences, and examiner expertise.

Main Results:

• Malignancy risk is elevated in incidental pulmonary nodules with specific risk factors and imaging findings.
• A systematic approach combining clinical and imaging data aids in determining the optimal diagnostic pathway.
• Emerging technologies offer minimally invasive options for diagnosing peripheral nodules.

Conclusions:

• Accurate pathological diagnosis of incidental pulmonary nodules is essential, especially for malignancy.
• Risk stratification and patient-specific factors guide the diagnostic strategy for lung nodules.
• Minimally invasive sampling technologies are advancing the management of peripheral pulmonary nodules.