Clinics in chest medicine
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Clinics in chest medicine · Mar 1993
ReviewEvaluation and management of solitary and multiple pulmonary nodules.
Solitary pulmonary nodules are malignant in 50% of cases. The 5-year cure rate after resection of a malignant nodule averages 50% and is even higher if the nodule is small. Stability for 2 years suggests benignity, and the presence of calcification in certain patterns indicates that the nodule is probably benign. ⋯ The "wait and watch" strategy may be advisable under certain circumstances. Multiple pulmonary nodules are usually due to metastatic spread from an extrapulmonary primary tumor. Biopsy is usually advisable because the nodules may be due to a curable benign process.
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Pleural effusions are common in the setting of lung cancer. A pleural effusion associated with lung cancer is an ominous finding, but a small percentage of patients are candidates for curative surgery. ⋯ When a malignant pleural effusion is diagnosed, the clinician must decide on the most appropriate form of palliation for the symptomatic patient. In the symptomatic patient with a reasonable life expectancy and pleural fluid pH of more than 7.3, chemical pleurodesis appears to be the most effective and least morbid therapy.