Signs, Causes and Treatment of Syncope (Fainting)
When To Worry About Lung Nodules Plus How To Prevent Them
Picture this: Your doctor orders an imaging test like a chest X-ray in preparation for an upcoming procedure, and the results show a small white spot in the center of your lungs—a pulmonary or lung nodule. Suddenly, you're wondering what this means for your health. Should you be concerned? Here, doctors explain when to worry about lung nodules, symptoms to look for plus how to prevent them in the first place.
What are lung nodules?"A lung nodule is a small, solid, rounded mass of tissue in the lungs that can be seen on a chest computed tomography (CT) scan or X-ray as a white spot," explains Samir Shah, MD, an interventional radiologist and Chief Medical Officer at Qure.Ai.
Pulmonary nodules typically form when a bacterial or viral infection irritates the lung tissue. This causes a small clump of cells called a granuloma to form. The nodules can also be caused by air pollution, fungal infections and autoimmune diseases like rheumatoid arthritis (RA). In fact, up to 32 percent of RA patients have lung nodules.
But is a lung nodule something to worry about? First, the good news. About 95 percent of lung nodules are benign or noncancerous and nothing to worry about. Still, pulmonary nodules shouldn't be ignored.
"One of our most important jobs is figuring out which nodules require further attention and which ones don't," says Scott Oh, DO, co-director of UCLA interventional pulmonology and clinical professor of medicine at the David Geffen School of Medicine at UCLA.
Symptoms of lung nodulesConsidering the location of the nodules, you might assume they present an array of side effects. However, most lung nodules present no symptoms, says Steven Davis, MD, an associate professor of internal medicine at the Burnett School of Medicine at TCU.
"If [a nodule] is large and close enough to an airway to block it off, a patient might experience shortness of breath or a cough," he notes. "And, if it's related to active pneumonia, symptoms could include fever, chills and a cough or shortness of breath."
But these manifestations are the exception, not the rule. Studies show 95 percent of lung nodules are asymptomatic.
How are lung nodules diagnosed?warodom changyencham
Because lung nodules rarely present symptoms, Dr. Shah says they're often detected unintentionally "when medical imaging is done for other reasons." For example, your doctor might notice a lung nodule while taking chest X-rays or CT scans for pneumonia or other issues.
Dr. Davis echoes this insight, adding that CT scans are generally more effective at identifying lung nodules than X-rays. Since X-rays provide lower-resolution images, Dr. Davis says they can only detect larger nodules. CT scans, on the other hand, produce more detailed photos and are better at identifying lung nodules of all sizes.
When to worry about lung nodulesMost lung nodules benefit from a "wait and watch" approach, according to Dr. Oh. Routine monitoring with CT scans can check for growth and other changes that might indicate the nodule is cancerous.
That said, you might worry more about lung nodules if you have certain risk factors. "For example, a patient in their 60s with a history of smoking-related emphysema and a first-degree relative with lung cancer is at higher risk than someone in their 20s who has never smoked," Dr. Oh explains. "Several [other] factors can [also] confer a higher level of concern, including the size, density and borders of the lung nodule, its location and if it changes over time."
If you have a history of lung disease, your healthcare provider may order additional tests like bloodwork or a lung biopsy to determine your risk of lung cancer and guide your treatment plan.
How to reduce your risk of lung nodulesJacob Wackerhausen
The experts we interviewed say there's no way to prevent lung nodules entirely, but you can reduce your risk by taking good care of your respiratory health. Obviously, if you smoke you should strive to quit—but avoiding exposure to air pollution and infections helps reduce the risk of lung nodules, too. Staying current on your vaccines and wearing an N-95 mask in crowded places or when there's poor air quality can help support these efforts.
A lung cancer screening is also beneficial. Dr. Oh says the United States Preventive Services Task Force encourages you to undergo lung cancer screening if you:
Are 50-80 years old
Have a history of smoking for at least 20 pack-years (e.G., one pack per day for 20 years, or two packs per day for 10 years)
Currently smoke or quit smoking in the last 15 years
"Finding [lung] nodules, figuring out which ones are cancer and getting them treated as early as possible are critical to improving lung cancer outcomes," Dr. Oh assures. "Please get screened if you qualify, and if you have a nodule that is incidentally detected, get it evaluated."
More ways to manage your breathing
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This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.
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Thyroid Nodules On CT Scan Generally Have Low Risk For Malignancy
Most thyroid incidentalomas on computed tomography (CT) are benign, according to findings from a systematic review and meta-analysis published in Thyroid.
Guidelines about thyroid incidentaloma surveillance from the American Thyroid Association and American College of Radiology are conflicting.
To clarify the risk for malignancy for CT-identified nodules, investigators from the University of Alabama at Birmingham in the United States searched publication databases through April 2024 for cohort studies and randomized controlled trials reporting incidence and follow-up of thyroid nodules among patients with no history of thyroid disease.
The analysis included a total of 49 articles, of which 47 were cohort and 2 were randomized controlled trial designs. Study authors identified incidentalomas through text extraction of previous CT reports (59.2%) or through radiologist reevaluation (40.8%). The studies used chest CT alone (44.9%), neck CT alone (26.5%), or both/unspecified. Contrast was used in 44.9% of studies.
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Thyroid incidentalomas are not uncommon findings on CT and generally have a relatively low risk of malignancy.
The pooled study population comprised 235,765 patients (mean [SD] age, 56 [12] years), of whom 54.9% were women. The patients were undergoing CT for miscellaneous reasons (40.8%), trauma (16.3%), lung cancer screening (10.2%), and COVID-19 screening (8.2%).
The pooled prevalence of thyroid incidentalomas was 8.3% (95% CI, 7.4%-9.3%; I2, 99.3%).
The prevalence of thyroid incidentalomas was higher for:
Among individuals with incidentalomas, the rate of multiple incidentalomas was 27.0% (95% CI, 12.9%-41.1%; I2, 96.1%). The rates of incidentalomas with a size of at least 1 cm and at least 1.5 cm were 46.3% (95% CI, 32.3%-60.3%; I2, 97.5%) and 28.6% (95% CI, 19.9%-37.3%; I2, 85.7%), respectively.
The proportion of patients with incidentalomas who underwent follow-up biopsy was 28.4% (95% CI, 19.9%-36.9%; I2, 95.9%) and thyroid surgery was 8.2% (95% CI, 2.1%-14.4%; I2, 87.1%).
The pooled malignancy rate was 3.9% (95% CI, 3.0%-4.9%; I2, 92.3%).
Malignancy rates were similar in studies using test extraction vs radiologist reevaluation (PP, 6.0% vs 4.2%), neck CT vs chest CT (PP, 6.5% vs 3.6%), and contrast vs no contrast (PP, 5.5% vs 3.6%).
The malignancy rates were higher for:
Study limitations include between-study heterogeneity.
The study authors concluded, "Thyroid incidentalomas are not uncommon findings on CT and generally have a relatively low risk of malignancy."
Cizzle Biotechnology Announces North American Licensing Deal To Launch Revolutionary Early Lung Cancer Blood Test In 2025
LONDON, Oct. 21, 2024 /PRNewswire/ -- Cizzle Biotechnology Holdings plc (Cizzle), the UK based diagnostics developer, is pleased to announce that it has signed an exclusive licensing agreement with Cizzle Bio granting exclusive rights to commercialise its proprietary CIZ1B biomarker test to help detect early-stage lung cancer across the USA. This is the first step in the company's global licensing and partnership strategy to bring our non-invasive, cost-effective CIZ1B biomarker lung cancer blood test to market in 2025.
The deal represents a major milestone for Cizzle and strengthens its position in the global diagnostics market by securing future revenue streams and funding for all clinical evaluations, accreditations, and marketing efforts in North America, allowing operations to quickly scale up whilst enabling Cizzle to pursue additional strategic goals, such as entering new geographic markets and advancing the development of a point-of-care (POC) test.
Whilst the renowned Moffitt Cancer Center in Florida conducts a major clinical evaluation of the CIZ1B biomarker lung cancer test in a real-world, high-volume clinical environment, the target is to secure CLIA accreditation for the test by the end of 2024, with a full product launch in North America planned for April 2025.
The results from this and other planned clinical evaluations could further validate the test's potential to differentiate between malignant and benign lung nodules, paving the way for broader clinical use.
This agreement is an integral part of Cizzle's global expansion plan to deliver non-invasive, cost-effective diagnostic tools for the early detection of lung cancer. The company's vision remains to improve early cancer detection and reduce mortality rates through accessible, cutting-edge diagnostic solutions.
Allan Syms, Executive Chairman of Cizzle Biotechnology, commented: "This partnership marks a significant step in our global licensing and commercialisation strategy. The structure of the agreement not only secures immediate and long-term revenue for Cizzle, but also positions us to expand into new markets and drive further innovation, such as our point-of-care test. By collaborating with a highly experienced and well-funded US-based team, we are accelerating the delivery of our CIZ1B biomarker test to market, bringing hope to millions of patients through early lung cancer detection."
About Cizzle BiotechnologyCizzle is developing a blood test to help in the early detection of lung cancer. Based on the pioneering work of Professor Coverley and colleagues, at the University of York, on a naturally occurring cell nuclear protein involved in DNA replication called CIZ1, they discovered that a variant called CIZ1B is highly associated with the presence of early-stage cancer. The company has now entered into commercial royalty bearing licensing agreements and collaborations with leading centres of excellence in cancer for the use of its proprietary technology as part of its strategy to bring its non-intrusive, cost-effective blood test to market.
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