Initial evaluation-solitary pulmonary nodule

• History: h/o cancer, smoking, age (<30 y = 2% malignant, +15% each decade >30)

• CT: size/shape, Ca2+, LAN, effusions, bony destruction, compare w/ old studies

Ø Ca → ↑ likelihood malignant; laminated → granuloma; “popcorn” → hamartoma

• High-risk features for malig: size (eg, ≥2.3 cm diameter), spiculated, upper lobe, ♀, >60 yo, >1 ppd current smoker, no prior smoking cessation (NEJM 2003;348:2535 & 2013;369:910)