Objective: To arrive at correct diagnosis of pulmonary solitary nodule by clinical manifestation and chest CT scan.
Methods: Ninety-eight patients with pulmonary solitary nodule were treated from 1990 to 2000. Their CT findings with clinical manifestations were correlated with the pathology results.
Results: Of 98 patients, there were 46 (46.9%) lung cancers, 14 (14.3%) benign tumors, 38 (38.8%) tuberculosis. Fifty-six (57.1%) patients had been asymptomatic or only associated with cough and sputum. 50% of these patients had stage I lung cancer. Tuberculosis was diagnosed more frequently in young patients with protracted feverishness, night sweats, chest and back pain, whereas lung cancer was more common in older patients who were asymptomatic or associated only with cough, sputum and hemoptysis. Lesions with well-defined margin, smooth and in the middle lobe by chest CT was suggestive of benign tumor, while those with irregular margin, un-even density, spiculated margin, lobulated contour and pleural shrinkage were more commonly associated with lung cancer. Those with calcification and in the lower lobe implied tuberculosis.
Conclusion: Screening of high risk population is useful in finding early lung cancer. Pulmonary solitary nodule can be correctly diagnosed chiefly by referring to the clinical manifestations and characteristics of chest CT scans. Nodules less than 1cm across are difficult to diagnose and, therefore, exploration is indicated.