Diagnostic Evaluation of the Solitary Pulmonary Nodule: First Be Sure It's There

Abstract

Solitary pulmonary nodules are frequent incidental findings on admission chest radiographs of hospitalized patients, as well as in healthy persons examined for other reasons. Diagnostic evaluation of such nodules often proceeds according to a routine protocol that includes computerized tomography, bronchoscopy, or percutaneous needle aspiration. We present two patients, referred to chest specialists for just such evaluation, whose solitary pulmonary nodules proved to be apparent rather than real. Had the simple, safe procedures of careful physical examination and chest fluoroscopy not been employed first, these patients might have been exposed to needless risk and subjected to unnecessary discomfort and expense in searches for nonexistent lesions.