When physicians detect a spot during a routine chest X-ray or computed tomography (CT) scan, they will investigate it to determine the cause. A lung nodule or mass typically refers to a growth occurring anywhere in the lungs. Most nodules are harmless, called benign lung tumors, and often require observation only. In this case, the doctor will likely advise patients to adopt a “wait-and-see” approach, and monitor the growth over a period of months or years to see if it changes in shape or size.
However, a lung nodule “could be related to a cancer,” says Jonathan Puchalski, MD, a pulmonologist at Yale Medicine. The likelihood that a lung growth is cancerous depends upon many factors, including a patient’s age, his or her history of smoking, and exposure to potentially harmful carcinogens in the environment, such as asbestos. If cancer is detected, then it’s important seek treatment advice immediately.
The Thoracic Oncology Program (TOP) at Yale Medicine includes lung doctors, surgeons, radiologists, cancer doctors, smoking cessation experts, and others who work as a group to help determine whether a nodule or mass is likely benign or cancerous. Together we determine the appropriate investigation with a quick and thorough personalized approach.
What are the symptoms of a lung mass?
A wide range of symptoms may suggest that a patient has lung nodules or a lung mass.These include mild cough, shortness of breath, and wheezing. Other patients may experience weight loss, pain in the chest, or coughing up blood. However, many patients with a lung nodule or lung mass have no symptoms at all.
What causes a benign lung tumor?
The causes of non-cancerous lung growths include active infections, such as a lung abscess, as well as previous infection, such as tuberculosis. A lung abscess can develop due to a bacterial infection in the lungs, which causes some lung tissue to die and decompose. As a result, pus develops in that space and forms an abscess. Sometimes, there is no known cause of a patient's benign lung lesions. However, cancerous lung growths can be caused by exposure to environmental carcinogens, genetic factors, or by the spreading of a cancer within the body from another site.
How is lung mass diagnosed?
An abnormal nodule or mass can be seen on the lung through a chest X-ray or computed tomography (CT) scan. Many nodules are discovered incidentally, when physicians are looking for something else. In many cases, a doctor will advise monitoring without immediate treatment, because only a small proportion of lung nodules are cancerous.
In addition to imaging tests, a doctor may suggest a bronchoscopy. In this procedure, a doctor places a scope with a built-in camera through a sedated patient’s mouth, down the airway and into the lungs. Depending on what is seen, sometimes the physician will conduct a biopsy, which involves extracting a piece of tissue from the lung and then examining it under a microscope. Other biopsies may also be performed, including those by CT-guidance or surgery.
How is lung mass treated?
If the nodule is determined to be benign, it will be monitored for growth and changes over a period of time—from months to years. A doctor may suggest removing the nodule if a patient has symptoms or is a smoker or is at high risk of cancer. If a biopsy is done and shows the growth is cancerous, a doctor will help guide the patient toward the proper treatment.
What makes Yale Medicine’s approach to a lung mass special?
Teams of Yale Medicine health care providers work with patients to ensure that any suspicious-looking lung masses are investigated quickly. Our physicians have extensive experience and expertise in evaluating X-rays and CT scans, and then in performing the appropriate investigations. If biopsies are necessary, the procedure is performed by a highly experienced surgeon. If surgery or other treatments are required, the multidisciplinary team of Yale Medicine doctors will offer the highest quality personalized approach to patient care.