Black spots in the lungs generally refer to the relevant pathological manifestations found during chest imaging, which may suggest high-density foci, low-density foci, and localized fibrosis. 1. High-density foci: clinically, they usually refer to single or multiple small nodules, mostly suggesting tuberculosis or inflammation. 2. Low-density lesions: multiple cystic low-density lesions can be seen on imaging, which are common in chronic obstructive pulmonary disease (COPD) and preferred in middle-aged and old-aged patients with a history of smoking. 3. Localized fibrosis: such as microinvasive adenocarcinoma, carcinoma in situ and other early lung tumors. After discovering black spots in the lungs, physicians should clarify the cause and severity of the disease according to the distribution range, number, shape, location and accompanying symptoms of the black spots, and then carry out targeted treatment according to the actual situation.