根据美国的数据，女性偶然发现肺结节的发生率为每1000人年5.8例，男性为每1000人年5.2例。按照相关指南中的建议对其进行管理可以显着改善临床结果。计算机断层扫描 (CT) 显示的所有肺部结节中 95% 以上是良性的，但许多病例并未按照指南进行处理。在本文中，我们总结了适当的临床方法，并概述了相关的诊断研究以及何时应该进行这些研究。这篇综述基于 PubMed 选择性检索检索到的相关出版物。作者检查了自 2010 年以来发布的关于肺结节治疗的英文建议，并辅以德国肺癌指南的评论。一般来说，偶然发现的肺结节恶性风险较低，但随着尺寸的增大和结节的增大而显着上升。存在风险因素。当检测到此类结节时，根据大小，进一步建议要么进行胸部 CT 后续检查，要么进行正电子发射断层扫描 CT 和组织学活检的扩展评估。诊断评估应包括考虑任何早期影像学研究，这些研究可作为随时间可能增长的指示。对于风险因素很少或没有风险因素的患者，测量小于 6 毫米的单个结节不需要任何随访。结节尺寸超过 8 毫米的患者中，只有不到 10% 的患者被诊断出患有肺癌。偶然发现的肺结节管理指南的建议旨在防止过度治疗和治疗不足。如果怀疑有肿瘤，应由跨学科团队提供进一步护理。

According to data from the USA, the incidence of incidentally discovered pulmonary nodules is 5.8 per 1000 person-years for women and 5.2 per 1000 person-years for men. Their management as recommended in the pertinent guidelines can substantially improve clinical outcomes. More than 95% of all pulmonary nodules revealed by computed tomography (CT) are benign, but many cases are not managed in conformity with the guidelines. In this article, we summarize the appropriate clinical approach and provide an overview of the pertinent diagnostic studies and when they should be performed.This review is based on relevant publications retrieved by a selective search in PubMed. The authors examined English-language recommendations issued since 2010 for the management of pulmonary nodules, supplemented by comments from the German lung cancer guideline.In general, the risk that an incidentally discovered pulmonary nodule is malignant is low but rises markedly with increasing size and the presence of risk factors. When such a nodule is detected, the further recommendation, depending on size, is either for follow-up examinations with chest CT or else for an extended evaluation with positron emission tomography-CT and biopsy for histology. The diagnostic evaluation should include consideration of any earlier imaging studies that may be available as an indication of possible growth over time. Single nodules measuring less than 6 mm, in patients with few or no risk factors, do not require any follow-up. Lung cancer is diagnosed in just under 10% of patients with a nodule measuring more than 8 mm.The recommendations of the guidelines for the management of incidentally discovered pulmonary nodules are intended to prevent both over- and undertreatment. If a tumor is suspected, further care should be provided by an interdisciplinary team.