Pulmonary Nodules Resected at Video-Assisted Thoracoscopic Surgery: Etiology in 426 Patients

Radiology. 1999 Oct;213(1):277-82. doi: 10.1148/radiology.213.1.r99oc08277.


Purpose: To determine the etiology of pulmonary nodules resected at video-assisted thoracoscopic surgery (VATS) and establish the probabilities that single or multiple nodules resected at VATS represent malignancy in patients with or patients without known cancer.

Materials and methods: Pathology reports from VATS performed between January 1995 and July 1997 were searched for data on gross specimens revealing pulmonary nodules 3 cm or smaller. Findings were correlated with clinical and histologic data.

Results: In 254 patients with one nodule resected at VATS, the nodules were malignant in 108 patients with and in 32 patients without known cancer (P < .03). Among 172 patients with multiple nodules resected, at least one nodule was malignant in 85 patients with and in 20 patients without known cancer (P > .05). Nodules larger than 1 cm were more likely to be malignant than were smaller nodules (P < .002). In patients with known malignancy, nodules smaller than 0.5 cm were more likely to be benign, whereas nodules larger than 0.5 cm but smaller than 1 cm were more likely to be malignant (P < .001).

Conclusion: A single pulmonary nodule resected at VATS was more likely to be malignant in patients with known cancer. Nodules larger than 1 cm but smaller than 3 cm resected at VATS were more likely to be malignant. Nodules smaller than 0.5 cm were more likely to be benign.

MeSH terms

  • Humans
  • Lung Diseases / diagnosis*
  • Lung Diseases / pathology
  • Lung Diseases / surgery
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / secondary
  • Lung Neoplasms / surgery
  • Solitary Pulmonary Nodule / diagnosis*
  • Solitary Pulmonary Nodule / pathology
  • Solitary Pulmonary Nodule / surgery
  • Thoracic Surgery, Video-Assisted*