Lung Nodules: What Are They and What Happens Next?

If a scan shows a lung nodule, you may wonder what it means and what happens next. A lung nodule — also called a spot on the lung — is a common finding that can have several causes.

Your clinician may suggest watching the spot over time or taking a closer look. This depends on its size, appearance and other factors. Knowing what to expect can help you feel more prepared.

What is a lung nodule?

A lung nodule is a small, round or oval-shaped spot that shows up on a chest X-ray or CT scan. These spots are often found during a scan for another health concern or during lung cancer screening with low-dose CT (LDCT).

Most lung nodules do not cause symptoms, so people often don't know they have one until it appears on a scan.

What can cause a lung nodule?

A spot on the lung can develop for several reasons, including:

• Current or past infections
• Inflammation, or swelling, in the lungs
• Scar tissue from a past illness or injury
• Growths that are not cancer
• Exposure to harmful substances, such as asbestos or radon
• Lung cancer or cancer that has spread to the lung from another part of the body

Smoking is an important risk factor that doctors consider when checking a lung nodule. Your age, family health history and exposure to harmful substances can also help your care team understand your risk.

"Finding a lung nodule gives us information that we need to evaluate, but it doesn't give us the whole answer," said Bayhealth Pulmonologist and Critical Care Physician Margarita Gianniosis, MD. "We look at the size and appearance of the spot, whether it has changed over time and the patient's individual risk factors to determine the most appropriate next step."

Finding a lung nodule is the start of an evaluation, not a diagnosis.

What happens after a lung nodule is found?

The next step depends on the spot's size and appearance, along with your health history. For some people, the next step may be another CT scan after a certain amount of time. This helps your care team see if the spot has stayed the same or changed.

If the spot needs a closer look, your care team may suggest more scans or a biopsy. A biopsy is a procedure that takes a small sample of tissue for testing.

At Bayhealth, Ion robotic bronchoscopy is one way doctors can biopsy certain lung nodules. This technology uses a thin, flexible tube to help doctors reach small spots deep in the lungs without major surgery.

"Technology like Ion gives us the ability to reach areas of the lung that can be challenging to access using traditional techniques," said Dr. Gianniosis. "When a biopsy is needed, being able to reach these spots safely and accurately can help us get patients the answers they need and determine what comes next."

Your care team will help you understand which next step is right for you. Be sure to follow the recommended plan, even if you feel well.
When is a biopsy needed for a lung nodule?

Not every lung nodule needs a biopsy. Your care team will look at the spot's size, shape, location and any changes over time. They will also consider your health history and risk factors.

If more information is needed, a biopsy can help doctors learn more about the spot. Your care team will decide which type of biopsy is best for you.

What should I do if I have a spot on my lung?

If a scan shows a lung nodule, the most important step is to follow up with your clinician. Your clinician can review your scans and health history to decide if the spot should be watched or needs more testing. Keep any follow-up appointments and scans so your care team can check for changes.

Comprehensive lung care at Bayhealth

If a spot on your lung needs more testing, Bayhealth has specialists and technology to help you get answers. Our lung specialists, imaging teams and cancer care experts work together to guide patients through the next steps.

If you've been told you have a lung nodule, ask your clinician about a referral to the Lung Nodule Clinic at Bayhealth Pulmonology, Blue Hen. Call 302-608-5306 to learn more.