Multiple pulmonary nodules are small round growths on the lung. A related issue, called multiple bilateral pulmonary nodules, are growths that have developed on both lungs. The lung nodules may be caused by various conditions, such as lung lesions, infections, and certain lung diseases.
The nodules may show up on a chest X-ray as small, white shadows. Some medical professionals will refer to them as lung spots. They tend to be around 0.19 to 0.98 inches (5 to 25 mm) wide. It isn't always obvious from just an X-ray as to what's causing them, so further testing may be needed.
One cause of multiple pulmonary nodules is cancer, which could develop in the lungs or spread there from another, original tumor site. Benign or non-cancerous tumors can also cause them. The size of the nodules will help a physician make a diagnosis. Although any nodule can be cancerous, multiple lung nodules less than 0.98 inches (25 mm) are often benign and not caused by cancer. Lung infections, like pneumonia, can also be a cause.
Diseases that lead to inflammation in the lungs, such as Wegener's granulomatosis, can cause multiple pulmonary nodules to develop as well. People who work around a large amount of dust or other lung irritants, such as coal, can develop occupational lung disease. This condition may also be referred to as pneumoconiosis.
People with multiple lung nodules might not have any symptoms, and since they are small, they may not interfere with breathing. When there are very large numbers of nodules, a person may have coughing and shortness of breath.
Treatment will depend on what caused the nodules. Benign ones that don't cause symptoms may not need treatment. Cancerous tumors may be watched closely to see if they grow. If treatment is needed, surgery may be done.
There are several surgical procedures to remove multiple pulmonary nodules, and which one is performed may depend on the number of nodules and their location. A bronchoscopy may be performed, which involves inserting a scope into the lungs to see the growths. Additional surgical procedures to remove the nodules include a thoracotomy, which involves cutting through the chest to remove the nodules. When fewer nodules are present, a mini-thoracotomy may be an option. Since a small incision is used at the exact location of the nodules, it is considered minimally invasive.