With the aggravation of foggy weather, more and more patients with small lung nodules are encountered in outpatient clinics and wards. These nodules are often less than 1 cm in diameter, with atypical CT imaging features, and because the diameter is so small that metabolism is not significantly distinguished from normal lung tissue, PET-CT cannot discriminate between benign and malignant. But how to treat them? Is surgery necessary? How to review it? This nodule has been followed up for 11 months and has been seen in many hospitals, including many large hospitals in Beijing and Tianjin, and has undergone many anti-inflammatory treatments, but none of them could determine the nature of the nodule. It might be carcinoma in situ or precancerous lesion. The patient’s son was also very dutiful and fully trusted the doctor in terms of treatment and listened to my suggestion of surgery. I also gave 10 days of intravenous anti-inflammatory treatment before the surgery, and reviewed the CT once again, but the nodule remained unchanged, which strengthened my determination to operate. During the thoracoscopic surgery, the nodule was removed, the frozen pathology report was adenocarcinoma, and a total minimally invasive radical lung cancer surgery was done, and the patient recovered well after the surgery. Therefore, small nodules found in the lungs should never be ignored, even if there is no indication for surgery for the time being, they should be reviewed once every 3 months, and if there is any change in the size of the nodules, they should be treated by minimally invasive surgery in time. In addition, if the nodule still does not change in size after 3 reviews, minimally invasive surgical intervention is also recommended. Only about 10% of benign nodules in the lung are found.