Mr. Liu had a medical checkup at a hospital in Dongguan last month and found a shadow in his right upper lung after taking an X-ray, followed by a spiral CT showing a small nodule of about 0.8 cm in diameter. What is this nodule, is it lung cancer, or is it a benign lesion? There are many people who worry about the shadows (small nodules) in their lungs during medical checkups. According to experts, once a small nodule is found in the lung, there is no need to be overly nervous, and the most important thing is to actively seek a clear diagnosis from a specialist such as a thoracic surgeon, and not to be careless. Is asymptomatic small lung nodule lung cancer? Nowadays, chest X-ray and CT examination are the most common means to diagnose chest diseases. Many people sometimes find the words “lung shadow (small nodule)” on the report card after taking X-ray chest examination. Small nodules? Many people start to suspect whether they are suffering from lung cancer, and become highly nervous, which seriously affects their work and life. So, are these nodules the “bad ones”? Chen Gang, professor of thoracic surgery at the Cancer Center of Guangdong Provincial People’s Hospital, said that generally speaking, the diseases that can manifest as “lung shadows” include lung cancer, congenital abnormalities of lung development, and more common infectious lung diseases, including pneumonia, tuberculosis, bronchiectasis, pulmonary aspergillosis, etc. Knowing the above common causes of lung shadows, we can find that “lung shadows (small nodules)” do not necessarily mean lung cancer, and many benign diseases can also manifest as small nodules. Therefore, once a patient finds a small nodule in the lung, he or she should not be overly nervous, but should actively seek a clear diagnosis from a specialist in thoracic surgery, who will apply other auxiliary examinations, such as chest CT, fiberoptic bronchoscopy, CT localization puncture, sputum cell examination, etc. to further clarify the diagnosis according to the patient’s specific condition. In contrast to Mr. Liu, Mr. Yan was diagnosed with “tuberculosis” last year when a small nodule was found in his upper right lung after a cough was taken at a local hospital. After six months of anti-tuberculosis treatment, Mr. Zhen’s cough symptoms did not improve significantly. Recently, Mr. Zhen was hospitalized again for coughing and coughing up bloody sputum, and a CT examination revealed that the original lung mass had grown significantly, and he was finally diagnosed with “advanced lung cancer” and multiple lymph node metastases, which had lost the chance of surgical treatment. Prof. Chen Gang emphasized that there are several types of people who should not take it lightly when small shadows or nodules are found in the lungs during physical examination, and should actively consult a professional thoracic surgeon to receive regular further examination and timely treatment: (1) long-term smokers, those who have smoked for more than 20 years, those who smoke more than 20 cigarettes a day, or those who have passive smoking; (2) those who are over 40 years of age; those who have chest pain, cough, and unexplained blood in sputum. (3) Those with a family history of tumors, especially lung cancer; (4) Those with nodules of 1 cm or larger, with burr-like, lobulated or hairy glass-like changes. How to deal with suspected small lung nodules Prof. Chen Gang suggested that if small lung nodules are diagnosed as early stage lung cancer and surgically removed, the 5-year survival rate can reach over 80%, the significance of early and late detection is completely different for lung cancer patients. Due to the rapid development of spiral CT in recent years, more and more small nodules can be detected, and small lung nodules smaller than 2 mm can be detected, which makes it more difficult for doctors to diagnose and also brings some trouble to patients whether to receive treatment or not. Experts emphasize that we should pay full attention to the small shadows or nodules in the lungs found by physical examination, especially for the above-mentioned kinds of small nodules that are highly suspicious to the population, even if the nodules are less than 1cm in diameter, we can apply minimally invasive localization techniques and thoracoscopic surgery to make correct diagnosis and treatment of small lung nodules in a timely manner.