Pulmonary treatment for lung disease in Southern Nevada

The goal of Sunrise Hospital's comprehensive lung program is to diagnose lung cancer in its earliest stage possible. Since early detection is key, we are committed to educating the Southern Nevada community on the importance of lung cancer screening.

To speak to someone at the comprehensive lung program at Sunrise Hospital, call (702) 961-9324.

Our team of specialists from radiology, pulmonology, surgery and pathology hold monthly multidisciplinary case conferences that provide coordinated care on both inpatient and outpatient cases. Additionally, our nurse navigators serve as a liaison between you and your treatment team and assist you with answering your questions.

Lung cancer screening program

Sunrise Hospital and Medical Center is recognized as a lung cancer screening facility. To help find lung cancer earlier, our comprehensive lung program offers low-dose computed tomography (CT) scans of the lungs for high-risk individuals. Our lung cancer screening assessment tool can help you identify if you may be at high-risk for lung cancer.

Pulmonary nodules

A pulmonary nodule is a small, round or oval-shaped growth in the lung. It may also be called a “spot on the lung” or a “coin lesion.” Pulmonary nodules are smaller than three centimeters (around 1.2 inches) in diameter. If the growth is larger than that, it is called a pulmonary mass and is more likely to represent a cancer than a nodule.

What causes pulmonary nodules?

There are two main types of pulmonary nodules: Malignant (cancerous) and benign (noncancerous). Over 90 percent of pulmonary nodules that are smaller than two centimeters (around 3/4 inch) in diameter are benign.

Benign pulmonary nodules can have a wide variety of causes. Many are the result of inflammation in the lung because of an infection or disease producing inflammation in the body. The nodule may represent an active process or be the result of scar tissue formation related to prior inflammation.

Benign developmental lesions may also appear as nodules.

  • Infections: Most infections that appear as with pulmonary nodules cause little or no pain. Inflammation related to infections often forms what is termed a granuloma. A granuloma is a small clump of cells that form when lung tissue becomes inflamed. Granulomas form when the immune system isolates a substance that is considered foreign. Most of the time granulomas occur in the lungs, but they may also form in other parts of the body. They can become calcified over time, as calcium tends to collect in the healing tissue.
  • Noninfectious causes of benign inflammatory lung nodules: Noninfectious disorders such as sarcoidosis, Wegener’s granulomatosis and rheumatoid arthritis also show themselves with granulomas forming in the lungs.
  • Neoplasms: These are abnormal growths that may be benign or malignant.

Types of benign neoplasms include:

  • Fibroma (a lump of fibrous connective tissue)
  • Hamartoma (an abnormal grouping of normal tissues)
  • Neurofibroma (a lump made up of nerve tissue)
  • Blastoma (a growth made up of immature cells)

Types of malignant tumors include:

  • Lung cancer
  • Lymphoma (a growth containing lymphoid tissue)
  • Carcinoid (a small, slow-growing cancerous tumor)
  • Sarcoma (a tumor consisting of connective tissue)
  • Metastatic tumors (tumors that have spread to the lungs from cancer in another part of the body)

What are the symptoms of pulmonary nodules?

Typically, there are no symptoms associated with pulmonary nodules. If present, symptoms would be related to the condition that led to the nodule developing. If the patient is often without symptoms but may have a new cough, or cough up blood, the nodule could be from lung cancer,

Most of the time, a patient doesn’t know that he or she has a lung nodule until a chest X-ray or computed tomography scan (CT scan) of the lungs is performed.

How common are pulmonary nodules?

Countless pulmonary nodules are discovered each year during imaging exams and are referred to as incidental findings. Most nodules are noncancerous (benign). A solitary pulmonary nodule is found on up to 0.2 percent of all chest x-ray films. Lung nodules can be found on up to half of all lung CT scans. Risk factors for malignant pulmonary nodules include a history of smoking and older age.

How are pulmonary nodules diagnosed?

  • Chest x-rays and CT scans: These tests are usually done when a person sees their doctor for a respiratory illness. If there is an indication that there is a pulmonary nodule, your doctor will ask you about you medical history, including whether you have had cancer in the past. Your doctor may recommend that you undergo a CT scan to obtain a more detailed image of the nodule.
  • Positron emission tomography (PET) scans: This test uses a radiolabeled substance such as glucose that is absorbed by the nodule, and captures an image of the nodule’s metabolic activity level. Nodules can light up on PET scans if they are malignant or if there is active inflammation.
  • Biopsy: A small tissue sample is removed from the nodule with a needle so it can be examined under a microscope in this procedure. It may be performed when other tests are inconclusive to rule out the chance that a growth is malignant. Your doctor may perform an endobronchial ultrasound (EBUS) or bronchoscopy, which is a biopsy that inserts breathing tubes into the windpipe or airway to reach the nodule on the lung, or a needle biopsy, which inserts a needle through the chest wall and into the nodule.

If any of these tests are not able to clarify the nature of the nodule or if the nodule has a concerning appearance or growth pattern, it may be best to remove the nodule surgically.

How are pulmonary nodules treated?

If the pulmonary nodule is benign, it usually does not require treatment. If an active infection is found or a disease of inflammation in the body is diagnosed, the treatment would be based on the condition identified and the symptoms that are present.

If the nodule is malignant, there does not appear to be any spread of the cancer and the patient is fit, then the cancer should be surgically removed. If a non-surgical biopsy of a nodule with high concern for malignancy is done and the results are inconclusive, it is recommended that the nodule be taken out.

Surgical techniques to take out pulmonary nodules include:

  • Thoracotomy: This procedure is considered open lung surgery. A cut is made in the wall of the chest in order to remove pieces of diseased lung tissue. Patients usually have to remain in the hospital for a few days after the operation. The mortality risk is low. When possible, a mini-thoracotomy that is less invasive may be performed.
  • Video-assisted thoracoscopy: This procedure uses a thorascope, a flexible tube with a miniature camera on its end. The thorascope is inserted through a small cut into the chest wall. The camera allows the surgeon to view an image of the nodule on a television screen. This technique requires a smaller cut and a shorter recovery time than a thoracotomy does.

The best way to avoid getting a malignant pulmonary nodule is to quit smoking if you are a smoker.