Pulmonary nodule history and symptoms: Difference between revisions
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Overview
Pulmonary nodules are generally asymptomatic. In some cases, patients may develop non-specific symptoms, such as: dyspnea, hemoptysis, chronic coughing, wheezing, and chest pain. Obtaining the detailed history can be an important aspect of making a diagnosis of solitary pulmonary nodule, specific areas of focus when obtaining the history, include: previous infection of tuberculosis, previous or current smoking history, history of immunological conditions, high occupational risk profession, or recent traveling.[1]
History
- Obtaining the history is an important aspect of making a diagnosis of pulmonary nodule. Complete history will help determine the likelihood of malignancy, and the association with other conditions. Specific symptoms description such as duration, onset, and progression are important for making the diagnosis. Specific areas of focus when obtaining the history, are outlined below:[2]
- Age
- Family history of cancer
- Personal history of cancer
- Positive history of active/passive smoking
- Number of cigarettes/year
- Number of years/months of active smoking
- Nummber of years/months of second-hand smoking
- Number of years/months of smoking cessation
- Previous primary infection of tuberculosis
- Previous infection of tuberculosis
- Previous or current lung disease, such as:
- Chronic obstructive pulmonary disease
- Interstitial lung disease
- Several patient factors may influence the likelihood of a benign versus a malignant condition: these include previous exposure to smoke or other carcinogens such as asbestos, and previously diagnosed cancer or respiratory infections. A patient with airway symptoms, especially hemoptysis, is more likely to have cancer compared to a patient with no respiratory symptoms.
Symptoms
Common Symptoms
- The majority of pulmonary nodules are asymptomatic and are usually found incidentally
- The hallmark of malignant pulmonary nodule is chronic cough, weight loss, and hemoptysis
- Common symptoms that may be suggest of pulmonary nodule, include:[3][4]
- Dyspnea
- Hemoptysis
- Chronic coughing
- Wheezing
- Chest pain
- Abdominal pain
- Cachexia
- Fatigue
- Loss of appetite
- Dysphonia
References
- ↑ Alzahouri K, Velten M, Arveux P, Woronoff-Lemsi MC, Jolly D, Guillemin F (2008). "Management of SPN in France. Pathways for definitive diagnosis of solitary pulmonary nodule: a multicentre study in 18 French districts". BMC Cancer. 8: 93. doi:10.1186/1471-2407-8-93. PMC 2373300. PMID 18402653.
- ↑ Kaerlev L, Teglbjaerg PS, Sabroe S, Kolstad HA, Ahrens W, Eriksson M, Guénel P, Gorini G, Hardell L, Cyr D, Zambon P, Stang A, Olsen J (2002). "The importance of smoking and medical history for development of small bowel carcinoid tumor: a European population-based case-control study". Cancer Causes Control. 13 (1): 27–34. PMID 11899115.
- ↑ Hamilton, W (Dec 2005). "What are the clinical features of lung cancer before the diagnosis is made? A population based case-control study". Thorax. BMJ Publishing Group Ltd. 60 (12): 1059–1065. PMID 16227326. Unknown parameter
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ignored (help) - ↑ Lung cancer. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/lung/signs-and-symptoms/?region=ab Accessed on February 24, 2015