On CT chest, a solitary pulmonary nodule (SPN) 8 mm in diameter is found incidentally in a 60-year-old male ex-smoker. According to Fleischner Society 2017 guidelines for SPNs in high-risk patients, what is the recommended management for a solid 8 mm nodule?

• A No follow-up required
• B CT follow-up at 3 months
• C Immediate PET-CT and bronchoscopy
• D CT follow-up at 3 months, then consider CT at 18–24 months or PET-CT ✓

Explanation

Per Fleischner Society 2017 guidelines for solid pulmonary nodules in high-risk patients: nodules 6–8 mm require CT at 6–12 months, then CT at 18–24 months. For 8 mm nodules specifically in high-risk patients (age >40, smoking history, family history, occupational exposure), follow-up at 3 months is also acceptable, and CT or PET-CT at 3 months to assess growth/FDG avidity may guide the need for tissue sampling. No follow-up is recommended only for nodules <6 mm in low-risk patients. Immediate invasive workup is not appropriate for an 8 mm nodule.

Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.