Lung Nodule Program

If you've recently learned you have a spot on your lung, take a deep breath. More than 90% of lung nodules are NOT cancerous and are often caused by minor inflammation or scar tissue from healed infections.

Understanding Lung Nodules

It's natural to feel a wave of anxiety when you hear you "have a spot on your lung" or see "pulmonary nodule" on a radiology report—especially for a test that had nothing to do with your lungs in the first place.

Virtua's specialized Lung Nodule Program is here to ease your concerns. We provide prompt evaluations, personalized monitoring, and clear guidance every step of the way, so you aren't left worrying about your health—or wondering what comes next.

What exactly is a lung nodule?

A lung nodule is a spot or growth in the lung, typically smaller than a pencil eraser. Most are benign (noncancerous). Lung nodules are common, found in up to 50% of adults, but they often go undetected because they rarely cause symptoms.

Lung nodules are usually an "incidental finding," discovered during an imaging test (usually a CT scan or X-ray) for an unrelated issue, such as a persistent cough or abdominal pain. They can also be detected during high-risk lung cancer screenings recommended for individuals with a history of smoking.

While most lung nodules are noncancerous scar tissue from a previous illness like the flu or pneumonia, they can also result from inflammation linked to autoimmune conditions such as sarcoidosis or rheumatoid arthritis.

Lung Nodule Sizes and Monitoring

If you were told you have a lung nodule, you'll meet with our team to discuss your results and next steps

The size and appearance of lung nodules on a CT scan, along with other risk factors, are crucial in determining your care plan. Our team follows the Fleischner Guidelines—the national, evidence-based standard for safely managing lung nodules.

Here's a clear breakdown of common nodule sizes and the typical monitoring or action plans based on whether you're low-risk (minimal to no smoking history) or high-risk (a smoking history or other clinical risk factors):

• Under 6 mm (smaller than a pencil eraser)
  • Low-risk: no follow-up needed
  • High-risk: follow-up CT scan in 12 months
• 6 mm – 8 mm (pea-sized)
  • Low-risk: follow-up CT scan in 6 to 12 months
  • High-risk: follow-up CT scan in 12 months
• Over 8 mm (marble-sized or larger)
  • All patients: Requires further evaluation, which may include a follow-up CT scan at 3 months, a PET/CT scan, or a tissue biopsy.

Based on your risk profile, your doctor may recommend follow-up CT scans at regular intervals—such as every 3, 6, or 12 months—over a few years. Because non-aggressive nodules grow slowly, watching a small spot over time is a safe, proven approach that avoids unnecessary procedures while ensuring you receive prompt care if anything changes.

If your nodule remains stable over two years, it's considered benign and typically requires no further imaging or treatment.

Lung Nodule Diagnosis and Treatment

If your scan shows that your nodule has grown or changed, or if it appears suspicious from the start, our team may recommend a closer evaluation.

Recommending advanced testing doesn't automatically mean you have cancer. Taking a tissue sample (biopsy) is often the fastest way to get a clear, definitive answer, so our team of experts can create an appropriate treatment plan for you.

At Virtua, we use minimally invasive techniques whenever possible and explain each step before any procedure.

This includes:

• Robotic-assisted bronchoscopy: If a nodule is near the center of your airway, an interventional pulmonologist can perform a biopsy using robotic-assisted bronchoscopy. Performed under anesthesia, the procedure uses robotic navigation to guide a thin tube into the airway to view and sample the nodule.
• CT-guided needle biopsy: If the nodule is near the outer edges of your lung, the interventional pulmonologist will use precise CT imaging to guide a small needle through the chest wall to obtain a tissue sample.

Surgical evaluation and minimally invasive treatment

If surgery is recommended to evaluate or remove your lung nodule, our thoracic surgeons specialize in video-assisted thoracic surgery (VATS) and robotic thoracic surgery. These minimally invasive approaches use tiny incisions, high-definition camera assistance, and specialized instruments, resulting in less pain, fewer complications, and a faster recovery.

Take the next step with confidence

Whether you recently received an incidental scan result, need to schedule a routine monitoring CT, or want a second opinion from our specialized team, we're here to support you.

• Call a lung nurse navigator: Speak directly with our team by calling 856-247-7393.
• Explore our services: Learn more about Virtua pulmonology services or our comprehensive lung cancer care program.