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Old 07-27-2013
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Default Solitary pulmonary nodule

MTB, KLN and Uworld have completely different classifications and algorithms for diagnosing a solitary pulmonary nodule, with virtually no overlap! What have/did most of you guys done regarding it? Which source would you trust?
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Old 07-27-2013
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Yes, this is confusing!

I think step up has more or less "ok" algorythm.
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Old 07-28-2013
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Eventho this is a confusing topic almost all agree with the first step, which is ask For previous chest xrays
Follow what uworld says, out of the 3 is the most reliable
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ask for previous xray
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Old 07-28-2013
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Previous cxr is clear as day, all sources state that!

The confusion comes with what size of an spn makes you wanna do surgery...

Some sources state >1 cm, some say >2
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Quote:
Originally Posted by DocSikorski View Post
Previous cxr is clear as day, all sources state that!

The confusion comes with what size of an spn makes you wanna do surgery...

Some sources state >1 cm, some say >2
Follow uworld
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Old 07-28-2013
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here is the UW algorythm

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Last edited by DocSikorski; 07-28-2013 at 04:02 PM.
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Quote:
Originally Posted by DocSikorski View Post
here is the UW algorythm

Yup this is the algorithm i memorized, remember also de criteria that makes a nodule more likey or not to be malignant (popcorn vs eccentric calcification, pt smoker or not, >35 or <35 yeara and so on) that table found on MTB 3 + this algorithm is what I use!
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Old 07-30-2013
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what i go based on (and it has not failed me yet):

1) CXR shows a nodule
2) Check old Xray to see if its growing
- if not growing, dont worry about
- if so, move on
3) CT scan to look at it properly and define its characteristics
4) CT scan will show you characteristics of benign or malignancy
- benign = <1-2 cm, calcifications present, in a nonsmoker, guy is less than 35yrs old, normal borders, etc etc
- malignant suspicion = the opposite
5) if benign, just do serial CTs every 6-12 months
if malignant, do a biopsy and either CTs of other areas or PET scan to r/o metastasis
6) biopsy shows small cell CA - chemo
biopsy shows non small cell CA - surgical resection if localized, radiation and chemo if not localized

it's pretty simple actually, ive always found these questions to be easy questions. surprised there's any confusion here.
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