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Pulmonary Nodule — RACP Adult Medicine MCQ

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ModerateRespiratoryPulmonary NoduleRACP Adult Medicine

A 55-year-old man who is a current smoker (30 pack-years) has a 6 mm solid pulmonary nodule found on CT chest. No prior imaging is available for comparison. The Brock model estimates malignancy risk at 3%. What is the most appropriate next step?

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Correct answer: D — Repeat CT in 12 months

A solid nodule 6–8 mm in a high-risk patient (smoker) with low predicted malignancy risk (Brock <5%) should be followed with repeat CT at 12 months to assess stability or growth. If stable at 12 months, a further scan at 24 months is recommended. Growth warrants tissue diagnosis.

Reference: eTG Respiratory – 2024 – Pulmonary Nodule; Fleischner Society 2017