Nódulo pulmonar: uma abordagem diagnóstica

Abstract

The pulmonary nodule is a frequent radiological finding and represents a clinical challenge due to the need to distinguish between benign and malignant etiologies. This review analyzed the main international guidelines — the Fleischner Society, the American College of Chest Physicians, and the British Thoracic Society — focusing on their specific differences in risk stratification, radiological characteristics, and diagnostic methods. There was convergence regarding the importance of a structured evaluation, but divergences were noted in probabilistic calculation methods, risk thresholds, and indications for PET-CT and biopsy. When considering the Brazilian context, limitations related to unequal access to advanced technologies become evident, requiring practical adaptation of the proposed algorithms. It is concluded, therefore, that the approach to pulmonary nodules must integrate scientific evidence, resource availability, and individualized clinical judgment to ensure safe and efficient management while avoiding unnecessary interventions.