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Fleischner Incidental Pulmonary Nodules

Fleischner Society (2017)

Follow-up recommendations for pulmonary nodules found incidentally on CT in adults 35 years or older, combining nodule number, composition (solid, part-solid, or pure ground-glass), mean size, and clinical risk of malignancy.

Also searched as: ground-glass · part-solid · follow-up · lung

Number of nodules
Nodule composition (solitary nodule)
Are any of the nodules solid? (multiple nodules)
Clinical risk of malignancy

High risk includes heavier smoking history, carcinogen exposure, family history, emphysema/fibrosis, upper-lobe location, and suspicious morphology.

Long-axis diameter of the dominant nodule
mm
Short-axis diameter of the dominant nodule
mm
Information
Incomplete input
  • Please provide: nodule count (solitary vs multiple), clinical risk category (low vs high), long-axis diameter (mm), short-axis diameter (mm).

How this tool works

The Fleischner Society 2017 guideline manages incidental nodules by size bands (under 6 mm, 6–8 mm, over 8 mm) and by composition. Solid nodules are triaged by size and patient risk, whereas subsolid nodules require confirmation of persistence and longer surveillance because of their indolent biology; for part-solid nodules the solid component drives decisions. Multiple nodules are managed according to the most suspicious lesion. The guideline does not apply to lung cancer screening programs, immunocompromised patients, or patients with known cancer.

References

Implemented from the cited published sources. Educational use only; confirm against current guidelines before clinical use.

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