Lung Nodule

Most lung nodules are nothing to worry about—but it’s essential to get advice from experts in diagnosis and monitoring.

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Lung nodules, or small areas of abnormal lung tissue, are very common.

About 95% of nodules are benign (not cancerous) and don’t require treatment. These nodules can be caused by a past illness or other condition.

However, some nodules can be signs of early lung cancer. When caught early, lung cancer is very treatable.

If you have a nodule, it’s important to have an expert evaluate it to determine next steps.

University of Iowa Health Care pulmonologists, radiologists, and other specialists have years of experience in diagnosing and monitoring lung nodules.

They’ll work with you on a customized plan to manage your nodule. And because they’re national leaders in clinical research, you may be eligible for trials of new approaches and therapies.

How lung nodules are diagnosed

Lung nodules are usually too small to cause breathing problems or other symptoms. Most are smaller than 10 millimeters (about half an inch) in diameter.

Because most nodules don’t cause symptoms, they are often found during X-rays or CT scans for other issues.

For example, if you’re being treated by a cardiologist, you could have a CT scan of your heart. The radiologist who reads your scan might see a small spot on your lung, unrelated to your heart problem. This is called an “incidental finding” of a nodule.

Other nodules are found during lung cancer screening. If you’re a current or former smoker, talk to your primary care provider about whether lung cancer screening is right for you.

Causes of lung nodules

Benign lung nodules might result from:

A past lung infection
A past respiratory illness
Other illnesses like sarcoidosis or rheumatoid arthritis

Cancerous lung nodules can be caused by:

Cigarette smoking
Asbestos, fibers, or other irritants that are inhaled
Radon exposure
Other cancer that has spread to the lungs

How UI Health Care specialists evaluate and treat lung nodules

Every lung nodule is different. UI Health Care experts will customize a plan for the most effective way to address yours.

Our radiologists and pulmonologists are highly skilled in reading scans and evaluating lung nodules.

Some of the factors that determine the next steps after you’re diagnosed with a nodule include:

Size of the nodule
Density of the nodule
The nodule’s appearance: Is it round and smooth, or does it have irregular borders?
Whether the nodule has calcium deposits, which could indicate that it was caused by an infection
Your overall risk for lung cancer, including your family history and history of smoking

A plan customized for you by our lung nodule experts

Most lung nodules do not need to be biopsied or removed. Instead, “watchful waiting,” or regular monitoring over time, is often our first approach.

If your nodule is small and needs monitoring, your pulmonologist will put you on a schedule for low-dose CT scans:

Low-dose scans provide very detailed images of your lungs. Each scan uses much less radiation than a regular CT scan.
UI Health Care radiologists have special expertise in reading these images.
If your images show no nodule changes, your scans will happen at increasingly longer intervals. This lets your team track the nodule while exposing you to the lowest possible amount of radiation. Nodules that don’t grow or change over the scan period likely need no further treatment.

If your nodule is large, grows, or needs further evaluation, you may have one or more of the following tests:

Positron emission tomography (PET) scan
CT-guided needle biopsy to remove tissue from the nodule for examination by a pathologist
An advanced procedure called robotic bronchoscopy. Guided by a 3D map of your lungs, your pulmonologist can biopsy even very small nodules without incisions or cutting.
Video-assisted thoracic surgery (VATS), a minimally invasive procedure that can remove lung tissue through small incisions

If a biopsy finds cancer cells, UI Health Care offers the most advanced lung cancer treatments. Our medical and radiation oncologists, thoracic surgeons, and other specialists create a treatment plan tailored to your diagnosis and goals.

Expertise that's unmatched in the region

While lung nodules are very common, expert monitoring and treatment aren’t available everywhere.

UI Health Care’s lung nodule team includes specialists in pulmonology, radiology, thoracic surgery, oncology, and other areas.

The most specialized care:

UI Health Care is the only health system in the region with thoracic surgeons who specialize solely in lung surgery.

A collaborative team, focused on you:

UI Health Care specialists in COPD and interstitial lung disease work closely with the lung nodule team to provide seamless care.

The next generation of evaluation and treatment:

UI Health Care researchers are at the forefront of new ways to diagnose and treat lung conditions, including nodules. More than 70 clinical trials for lung cancer are currently underway. If you’re eligible, you may have access to new drugs and therapies not yet widely available.

Your path is your choice:

For many reasons, including other medical conditions or advanced age, some people decide not to treat cancerous lung nodules. If you decide not to treat, your team will work with you on a plan to keep you comfortable.