Pulmonary Nodule Treatment

What is a pulmonary nodule?

Pulmonary nodules are small, round growths located in the lungs. Nodules are smaller than three centimeters in diameter, look like spots on X-ray, and can be found on 0.2% of all chest x-ray films. Since nodular masses larger than this are considered tumors, measuring the size of the nodule can help doctors determine whether the growth  might pose the threat of cancer.
Although approximately 90% of pulmonary nodules are noncancerous or benign, nearly all of the remaining 10% are cancerous or malignant.

What causes pulmonary nodules?

Pulmonary nodules may be the result of an infection, scar tissue, pulmonary disease, or cancer.
As discussed, there are two primary kinds of pulmonary nodules: malignant (cancerous) and benign (noncancerous).

Benign pulmonary nodules may be caused by a number of factors, but in many cases the culprit is a disease or infection that has caused an inflammatory response. These diseases may be infectious or noninfectious. Mycobacterium, for example, is a group of infectious, disease-causing bacteria. The genus is responsible for the onset of conditions such as tuberculosis and leprosy. It is also a cause of benign pulmonary nodules. Rheumatoid arthritis, although a noninfectious condition, can also foreshadow the growth of pulmonary nodules. Regardless of the exact disease or bacterium, tissue inflammation of any kind can lead to what is known as a granuloma.

Granulomas are small aggregations of cells that form in the aftermath of tissue inflammation. These clumps can cause calcium, a hard mineral, to build up within the body tissue and make the granulomas increasingly rigid. While it can be unsettling to discover that these calcium deposits have settled into the lungs, it should be noted that benign pulmonary nodules do not usually require treatment and most likely will not impact one’s day-to-day life.

Malignant pulmonary nodules, as the name suggests, pose much more of a threat than their benign counterparts. When a pulmonary nodule measures at a size approaching or greater than 3 centimeters, it may be an early but serious sign of a cancerous tumor. Malignant pulmonary nodules and tumors can originate in the lungs themselves, or they may have spread to the lungs from other parts of the body in a process called metastasis.

All malignant pulmonary tumors should be managed by a medical professional as soon as possible.

How are pulmonary nodules diagnosed?

Both malignant and benign pulmonary nodules are usually diagnosed by administering an X-ray or a CT scan. Less commonly referred to as computed tomography, these scans can be understood as a digitized method of obtaining X-ray images.
Once X-ray photos or CT “slices” have been taken, a doctor assesses the visuals to determine the size, mineral composition, and threat level of the pulmonary growths.
Based on these findings, the patient and their health care provider will then discuss next steps for treatment, preventive measures, and surgery, if necessary.

A doctor describes the results of an x-ray to a man in a black suit and glasses. A monitor with two X-ray images of the torso stands before them.

Integra Health screens patients for pulmonary nodules using the best technology in modern medicine.

What can be done?

At Integra Health, we work diligently to ensure our community remains healthy. We screen our patients and provide additional testing on any pulmonary nodules found in order to determine the best course of treatment. There are typically no symptoms associated with pulmonary nodules, so you may not know you have one until a CT scan is conducted.
If you do have a pulmonary nodule, we may suggest a bronchoscopy. A bronchoscopy allows us to examine the air passages in your body with a small camera that is connected to a flexible tube. This device may also collect tissue samples from your lung that can be tested for disease. A bronchoscopy is quick, and patients are allowed to go home the same day as the procedure.


Endobronchial Ultrasound Bronchoscopy

Endobronchial ultrasound (EBUS) is a minimally invasive but highly effective procedure used to diagnose lung cancer, infections, and other diseases causing enlarged lymph nodes in the chest. Integra Health, PC is the first center in Temecula Valley to offer EBUS and remains a regional leader in volume and overall experience.

Why is EBUS used?

EBUS allows Dr. White to perform a technique known as transbronchial needle aspiration (TBNA) to obtain tissue or fluid samples from the lungs and surrounding lymph nodes without conventional surgery. The samples can be used for diagnosing and staging lung cancer, detecting infections, and identifying inflammatory diseases that affect the lungs, such as sarcoidosis or cancers like lymphoma.

What makes EBUS different?

Calcified Central Lymph Node

During a conventional diagnostic procedure, surgery known as mediastinoscopy is performed to provide access to the chest. A small incision is made in the neck just above the breastbone or next to the breastbone. Next, a thin scope, called a mediastinoscope, is inserted through the opening to provide access to the lungs and surrounding lymph nodes. Tissue or fluid is then collected via biopsy.

An endobronchial ultrasound is much less invasive.

  • Dr. White can perform needle aspiration on lymph nodes using a bronchoscope inserted through the mouth
  • A special endoscope fitted with an ultrasound processor and a fine-gauge aspiration needle is guided through the patient’s trachea
  • No incisions are necessary

What are the Benefits of EBUS?

Peripheral Lesion

  • It provides real-time imaging of the surface of the airways, blood vessels, lungs, and lymph nodes
  • The improved images allow Dr. White to easily view difficult-to-reach areas and to access more, and smaller, lymph nodes for biopsy with the aspiration needle than through conventional mediatinoscopy
  • The accuracy and speed of the EBUS procedure lends itself to rapid onsite pathologic evaluation Pathologists in the operating room can process and examine biopsy samples as they are obtained and can request additional samples to be taken immediately if needed
  • EBUS is performed under moderate sedation or general anesthesia
  • Patients recover quickly and can usually go home the same day


Get in touch with our team today. We look forward to providing you answers about pulmonary nodules or any other concerns you may have.

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