Spindle-shaped nodular shadows in the lungs are suggestive of a space-occupying lung lesion, which may be a benign or malignant nodule. Lung nodules are an imaging concept, and a dense shadow with a diameter of less than 3 centimeters found in the lung field on CT is a nodular shadow. There are three general categories of nodular shadows in the lungs, which are solid nodular shadows, ground glass nodular shadows, and mixed nodular shadows. Spindle-shaped nodular shadows in the lungs are described according to the morphology of the lung nodules and may be one of the three types of nodules mentioned above in nature. If the spindle-shaped nodular shadows in the lungs are solid, stable on regular examination, and show no obvious signs of growth, they are often benign space-occupying lesions, which may be related to the sequelae of inflammation in the lungs, and do not need to be treated. If the spindle-shaped nodular shadow in the lungs is like ground glass, other features should be observed. If the edge of the nodular shadow is not too clear and there is a burr sign around it, it may be the early stage of lung adenocarcinoma; if the shape is more regular and there is no burr sign, it may be a benign nodule. At this time, it is recommended to make a clear diagnosis based on tumor markers, enhanced CT examination results and even bronchoscopic biopsy.