Murrell et al identified a number of factors which can help to identify a solitary lung nodule in a pediatric cancer patient that should be biopsied. The authors are from Cincinnati Children’s Hospital.


Patient selection: pediatric patient with solitary lung nodule and a history of cancer


Conditions associated with metastasis (and need for lung biopsy):

(1) peripheral lesion (odds ratio 9)

(2) location in the right lower lobe (odds ratio 2.4)

(3) diameter 0.5 to 1.0 cm (not < 0.5 or > 1.0, odds ratio 2.8)

(4) history of any of the following:

(4a) osteosarcoma (odds ratio 11)

(4b) Ewing sarcome (odds ratio 3)

(4c) hepatocellular carcinoma (odds ratio 2.4)


The likelihood of the nodule being a metastasis increases with the number of conditions met.


To read more or access our algorithms and calculators, please log in or register.