• Ewa Wachuła, Sylwia Szabłowska-Siwik, Damian Czyżewski, Jerzy Kozielski, and Mariusz Adamek.
• Department of Oncology, Medical University of Silesia, Katowice, Poland
• Pol. Arch. Med. Wewn. 2020 Jan 31; 130 (1): 17-24.

IntroductionChest low-dose computed tomography (LDCT) has recently been proved effective in lung cancer screening.ObjectivesWe aimed to assess the association between the occurrence of emphysema and solitary pulmonary nodules (SPNs) in first‑round screening with LDCT.Patients And MethodsA total of 601 asymptomatic volunteers with a smoking history underwent LDCT; 523 patients were assigned to one of the following groups: E, emphysema without nodules (n = 103); E + N, emphysema with coexisting nodules (n = 96); N, nodules without emphysema (n = 142); and NENN, no nodules and no emphysema (n = 182). The effect of emphysema and demographic factors on the profile of SPNs was assessed.ResultsPatients in the E + N group were older than those in the N group (median age, 65 vs 63 years; P = 0.001) and they smoked more (median pack‑years, 37.8 vs 32; P = 0.01). Emphysema was detected in 199 of the 523 patients (38%), while nodules, in 238 (45.5%). The number of nodules in the E + N group was 390 (4.1 nodules per patient), and in the N group, 540 (3.8 nodules per patient). Multiple SPNs, of different size and morphology, constituted 93.3% of the nodules in the E + N group. Seven cases of cancer were detected among 238 patients with nodules, and their distribution was similar in the groups with and without emphysema (4.2 per 100 patients in the E + N group and 2.1 per 100 in the N group; P = 0.44).ConclusionsEmphysema was more frequently associated with multiple SPNs of different morphology among elderly patients with a higher number of smoking pack‑years.

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