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Previous Volume 348:2535-2542 June 19, 2003 Number 25 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.

A 60-year-old man undergoes chest radiography during an evaluation for pneumonia, and a nodule 1.5 cm in diameter is discovered. He is a heavy smoker but has no history of lung disease. The results of a physical examination are unremarkable. How should he be evaluated?

The Clinical Problem

A solitary pulmonary nodule is noted on 0.09 to 0.20 percent of all chest radiographs.^1,2 An estimated . . . [Full Text of this Article]

Strategies and Evidence

Definition

Improvements in Radiographic Imaging

Nonsurgical Approaches to Diagnosis

            CT Densitometry

            Contrast-Enhanced CT

            Bronchoscopy

            Transthoracic Fine-Needle Aspiration Biopsy

Areas of Uncertainty

Positron-Emission Tomography

Selecting a Diagnostic Strategy

Implications of Lung-Cancer Screening for Diagnostic Approaches

Thoracotomy and Video-Assisted Thoracoscopic Surgery

Guidelines

Conclusions and Recommendations

Source Information

From the Center for Pulmonary and Critical Care Medicine, North Shore University Hospital, Manhasset, N.Y. (D.O., A.M.F., S.H.F.); New York University School of Medicine, New York (D.O., S.H.F.); and the State University of New York at Stony Brook, Stony Brook (A.M.F.).

Address reprint requests to Dr. Ost at the Center for Pulmonary and Critical Care Medicine, North Shore University Hospital, 300 Community Dr., Manhasset, NY 11030, or at dost@nshs.edu.

Related Letters:

The Solitary Pulmonary Nodule
Ampel N. M., Ost D., Fein A. M., Feinsilver S. H.
Extract | Full Text | PDF  
N Engl J Med 2003; 349:1575, Oct 16, 2003. Correspondence

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