Solitary pulmonary nodule uncovered

Introduction: The approach to the solitary pulmonary nodule (SPN), pursuing a premature diagnosis of malignancy, remains a challenge in critical practice. Objectives: to evaluate the clinical and imaging characteristics of the nodule and determine the variables associated with malignancy. Methods: retrospective study, through review of clinical files of patients with SPN. Results: 47 patients were included, 51.1% female, with an average age of 63.4 years. On 66% of the patients lesion was seen on chest X-ray. Most nodules were located in the right inferior lobe (27.7%).The most prevalent etiologies were malignancy (36.2%), hamartoma (17%) and tuberculoma (6.4%). Malignant nodules were predominantly located in the right inferior lobe (35.3%), were > 2cm (70.6%) with solid attenuation (76.5%) and irregular/spiculated borders (76.5%); 47.1% had pleural tail and 17.6% had air bronchograms; no calcification or cavitation were seen on these nodules. 93.3% showed contrast enhancement on CT, mostly heterogeneous, and 84.6% FDG enhancement on PET-CT. Older age, nodule size, pleural tail, heterogeneous enhancement on CT and FDG enhancement on PET were statistically related to malignancy. Conclusion: Malignancy showed a prevalence of 36.2%. Older age, nodule size, pleural tail, heterogeneous enhancement on CT and enhancement on PET were statistically related to malignancy.