Pulmonary nodules following a lung transplant require ‘aggressive’ diagnostic evaluation, experts caution

Patients who develop pulmonary nodules after a lung transplant may require “aggressive” diagnostic evaluation, experts in Detroit cautioned on Wednesday.

Such scenarios are rare, with no support supporting guidelines for approaching patient management. With a “broad” differential diagnosis in this setting—often life-threatening without treatment—radiologists must be hyper-vigilant when this situation surfaces, according to an analysis in Clinical Imaging.

“In these cases, a broad differential diagnosis must be considered. Given the high mortality associated with the most common diagnoses, aggressive diagnostic evaluation is warranted,” corresponding author Javier Diaz-Mendoza, with the Department of Pulmonary and Critical Care Medicine at Henry Ford Hospital, and colleagues wrote Nov. 11.

Diaz-Mendoza, thoracic radiologist Thomas Song, MD, and co-authors detailed the case of a 70-year female who developed a large nodule in the native lung four years after a singular transplant. Providers started her on chemo, and she has demonstrated clinical improvement at the seven-month follow-up.

Before then, providers gathered front and lateral chest radiographs and a subsequent CT scan. They noted that the main diagnostic considerations for a pulmonary nodule after a transplant are malignancy and infection, based on a literature review.  

You care read more about the case study in Clinical Imaging here.

Marty Stempniak

Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic. 

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