An Approach to the Solitary Lung Nodule in Older Adults

Cherdchai Nopmaneejumruslers, MD, Senior Clinical and Research Fellow, Division of Respirology, University of Toronto, Toronto, ON.
Charles K.N. Chan, MD, FRCPC, FCCP, FACP, Head, Division of Respirology, University Health Network, Mount Sinai Hospital, Sunnybrook & Women's College Health Sciences Centre, University of Toronto, Toronto, ON.

A diagnostic dilemma of a solitary pulmonary nodule (SPN) is a common clinical problem in the older population. Most pulmonary nodules are discovered incidentally on chest radiographs. Signs and symptoms are rarely present until the disease has become advanced and unresectable. Therefore, a timely and accurate diagnosis of the etiology of an SPN in early stage is essential to provide an excellent prognosis following surgical resection. Based on the best evidence, the algorithm presented in this article was made to provide the clinician with a clinical management pathway of the solitary lung nodule in older adults.
Key words: solitary pulmonary nodule, lung cancer, PET scan, diagnostic workup, VATS.