Juxtapleural lung nodules
Disclosures
- updated 19 Aug 2022:
Nothing to disclose
Updates to Article Attributes
Body
was changed:
Perifissural lung nodules (PFNs) are a type of intrapulmonary nodulesnodule that, most of the timestime, represent pulmonary lymph nodes.
Terminology
Although perilymphatic pulmonary nodules can also be perifissural in distribution, they should be distinguished from perifissural lung nodules, as the former are usually associated with a number of conditions.
Radiographic features
CT
Perifissural lung nodules are typically seen as well-circumscribed, smoothly marginated homogeneous nodules in contact with or closely related to a pulmonary fissure. Most show a triangular, oval/lentiform, rectangular, or dumbbell shape. They may often show a septal attachment to the pleural surface 3.
Worrisome features that are not typical for lymph nodes and should be reported, prompting for imaging follow-up, include 6:
round morphology or contour irregularity
the adjacent fissure is abnormal: bowed, retracted, or transgressed
Treatment and prognosis
If perifissural lung nodules have typical morphology they are favoured to be benign despite some nodules having a tendency to grow over serial scans 2.
-<p><strong>Perifissural lung nodules (PFNs)</strong> are a type of <a href="/articles/intrapulmonary-nodules">intrapulmonary nodules</a> that, most of the times, represent <a href="/articles/intrapulmonary-lymph-nodes-1">pulmonary lymph nodes</a>. </p><h4>Terminology </h4><p>Although <a href="/articles/perilymphatic-lung-nodules">perilymphatic pulmonary nodules</a> can also be perifissural in distribution, they should be distinguished from perifissural lung nodules, as the former are usually associated with a number of conditions.</p><h4>Radiographic features</h4><h5>CT</h5><p>Perifissural lung nodules are typically seen as well-circumscribed, smoothly marginated homogeneous nodules in contact with or closely related to a pulmonary fissure. Most show a triangular, oval/lentiform, rectangular, or dumbbell shape. They may often show a septal attachment to the pleural surface <sup>3</sup>.</p><p>Worrisome features that are not typical for lymph nodes and should be reported, prompting for imaging follow-up, include <sup>6</sup>: </p><ul>-<li>round morphology or contour irregularity</li>-<li>the adjacent fissure is abnormal: bowed, retracted, or transgressed</li>- +<p><strong>Perifissural lung nodules (PFNs)</strong> are a type of <a href="/articles/intrapulmonary-nodules">intrapulmonary nodule</a> that, most of the time, represent <a href="/articles/intrapulmonary-lymph-nodes-1">pulmonary lymph nodes</a>. </p><h4>Terminology </h4><p>Although <a href="/articles/perilymphatic-lung-nodules">perilymphatic pulmonary nodules</a> can also be perifissural in distribution, they should be distinguished from perifissural lung nodules, as the former are usually associated with a number of conditions.</p><h4>Radiographic features</h4><h5>CT</h5><p>Perifissural lung nodules are typically seen as well-circumscribed, smoothly marginated homogeneous nodules in contact with or closely related to a pulmonary fissure. Most show a triangular, oval/lentiform, rectangular, or dumbbell shape. They may often show a septal attachment to the pleural surface <sup>3</sup>.</p><p>Worrisome features that are not typical for lymph nodes and should be reported, prompting for imaging follow-up, include <sup>6</sup>: </p><ul>
- +<li><p>round morphology or contour irregularity</p></li>
- +<li><p>the adjacent fissure is abnormal: bowed, retracted, or transgressed</p></li>
References changed:
- 1. Ahn M, Gleeson T, Chan I et al. Perifissural Nodules Seen at CT Screening for Lung Cancer. Radiology. 2010;254(3):949-56. <a href="https://doi.org/10.1148/radiol.09090031">doi:10.1148/radiol.09090031</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/20177105">Pubmed</a>
- 2. de Hoop B, van Ginneken B, Gietema H, Prokop M. Pulmonary Perifissural Nodules on CT Scans: Rapid Growth is Not a Predictor of Malignancy. Radiology. 2012;265(2):611-6. <a href="https://doi.org/10.1148/radiol.12112351">doi:10.1148/radiol.12112351</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/22929331">Pubmed</a>
- 3. Frank L & Quint L. Chest CT Incidentalomas: Thyroid Lesions, Enlarged Mediastinal Lymph Nodes, and Lung Nodules. Cancer Imaging. 2012;12(1):41-8. <a href="https://doi.org/10.1102/1470-7330.2012.0006">doi:10.1102/1470-7330.2012.0006</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/22391408">Pubmed</a>
- 4. Mets O, Chung K, Scholten E et al. Incidental Perifissural Nodules on Routine Chest Computed Tomography: Lung Cancer or Not? Eur Radiol. 2018;28(3):1095-101. <a href="https://doi.org/10.1007/s00330-017-5055-x">doi:10.1007/s00330-017-5055-x</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/28986629">Pubmed</a>
- 5. Snoeckx A, Reyntiens P, Desbuquoit D et al. Evaluation of the Solitary Pulmonary Nodule: Size Matters, but Do Not Ignore the Power of Morphology. Insights Imaging. 2018;9(1):73-86. <a href="https://doi.org/10.1007/s13244-017-0581-2">doi:10.1007/s13244-017-0581-2</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/29143191">Pubmed</a>
- 6. Bueno J, Landeras L, Chung J. Updated Fleischner Society Guidelines for Managing Incidental Pulmonary Nodules: Common Questions and Challenging Scenarios. Radiographics. 2018;38(5):1337-50. <a href="https://doi.org/10.1148/rg.2018180017">doi:10.1148/rg.2018180017</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/30207935">Pubmed</a>
- 1. Ahn MI, Gleeson TG, Chan IH et-al. Perifissural nodules seen at CT screening for lung cancer. Radiology. 2010;254 (3): 949-56. <a href="http://radiology.rsna.org/content/254/3/949.full">Radiology (full text)</a> - <a href="http://dx.doi.org/10.1148/radiol.09090031">doi:10.1148/radiol.09090031</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/20177105">Pubmed citation</a><span class="auto"></span>
- 2. de Hoop B, van Ginneken B, Gietema H et-al. Pulmonary perifissural nodules on CT scans: rapid growth is not a predictor of malignancy. Radiology. 2012;265 (2): 611-6. <a href="http://dx.doi.org/10.1148/radiol.12112351">doi:10.1148/radiol.12112351</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/22929331">Pubmed citation</a><span class="auto"></span>
- 3. Frank L, Quint LE. Chest CT incidentalomas: thyroid lesions, enlarged mediastinal lymph nodes, and lung nodules. Cancer Imaging. 2012;12 (1): 41-8. <a href="http://dx.doi.org/10.1102/1470-7330.2012.0006">doi:10.1102/1470-7330.2012.0006</a> - <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3335330">Free text at pubmed</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/22391408">Pubmed citation</a><span class="auto"></span>
- 4. Mets OM, Chung K, Scholten ET, Veldhuis WB, Prokop M, van Ginneken B, Schaefer-Prokop CM, de Jong PA. Incidental perifissural nodules on routine chest computed tomography: lung cancer or not?. (2018) European radiology. 28 (3): 1095-1101. <a href="https://doi.org/10.1007/s00330-017-5055-x">doi:10.1007/s00330-017-5055-x</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/28986629">Pubmed</a> <span class="ref_v4"></span>
- 5. Snoeckx A, Reyntiens P, Desbuquoit D, Spinhoven MJ, Van Schil PE, van Meerbeeck JP, Parizel PM. Evaluation of the solitary pulmonary nodule: size matters, but do not ignore the power of morphology. (2018) Insights into imaging. 9 (1): 73-86. <a href="https://doi.org/10.1007/s13244-017-0581-2">doi:10.1007/s13244-017-0581-2</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/29143191">Pubmed</a> <span class="ref_v4"></span>
- 6. Bueno J, Landeras L, Chung JH. Updated Fleischner Society Guidelines for Managing Incidental Pulmonary Nodules: Common Questions and Challenging Scenarios. (2018) Radiographics : a review publication of the Radiological Society of North America, Inc. 38 (5): 1337-1350. <a href="https://doi.org/10.1148/rg.2018180017">doi:10.1148/rg.2018180017</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/30207935">Pubmed</a> <span class="ref_v4"></span>
Unable to process the form. Check for errors and try again.