Lung nodules and pleural effusion
A nodule is a small spot on a lung scan, and most are benign. A pleural effusion is fluid around the lung and a sign of another condition. This page explains what to do with these results.
What is a lung nodule?
A nodule is a spot on an X-ray or CT that looks different from the tissue around it. It usually causes no symptoms and is found by chance. Radiologists see nodules in nearly one in three chest CTs.
A nodule can be the mark of an infection, inhaled particles, inflammation, scarring or a benign tumour, and sometimes cancer. Most nodules are not cancer, but a scan alone cannot confirm or exclude cancer.
What changes the likelihood?
- The nodule’s size and appearance
- Smoking, now or in the past
- Older age
- A personal or family history of cancer
- Radiation to the chest
- Exposure to asbestos, radon or second-hand smoke
What does a follow-up plan mean?
For many nodules a repeat CT is done after 6 to 12 months. If suspicion is higher, a PET scan, a biopsy or removing the nodule is considered. A nodule from an infection may need medicine. Do not put off your follow-up, and always bring your previous CT, because comparison with it matters a great deal.
What is a pleural effusion?
Two thin layers cover the lung, and a little fluid between them keeps it moving smoothly. When the body makes too much fluid or cannot clear it, it builds up.
An effusion is not a disease in itself but a sign of another cause: heart failure, liver cirrhosis, kidney disease, pneumonia, tuberculosis, inflammatory disease or cancer. Common symptoms are chest pain with coughing or deep breaths, and breathlessness. Many people have no symptoms, and it is found on an X-ray taken for something else.
How is it assessed and treated?
After an examination, a chest X-ray, ultrasound or CT is done. If the cause is unclear, a fluid sample is taken with a needle between the ribs for testing. If there is a lot of fluid and it makes you breathless, the same procedure is used to drain it.
The main treatment is treating the cause: medicines for heart failure, antibiotics for infection, or specific treatment for other causes. If the fluid returns, a chest tube or other methods may be needed.
When should you act urgently?
Chest pain, difficulty breathing or coughing up blood do not wait for your follow-up appointment.
Frequently asked questions
Why not biopsy a nodule straight away?
Many nodules are small and benign, and a biopsy has its own risks. So follow-up CTs are often the best route. The decision depends on the nodule's size and appearance and your personal risk.
If a nodule does not grow, can I relax?
A nodule that has not changed in size over two years is unlikely to be cancer. Even so, your doctor decides when follow-up ends.
Does draining pleural fluid hurt?
It is done with a needle between the ribs. Ask the centre doing it about numbing and preparation. People usually need to take it easy for about two days afterwards.
The first step, a calm conversation.
Go to the booking page or talk to support. Have your earlier results and scans ready.