The role of bronchoscopy in the diagnosis of solitary pulmonary nodules in 2025

Solitary pulmonary nodules (SPN) are an increasingly common clinical challenge and will continue to place a huge burden on healthcare systems for at least another 30 years. They are problematic due to their variable malignant potential and diverse etiology. The number of detected nodules is rapidly increasing and will certainly continue to do so in the future (1). This is due to the widespread use of computed tomography and the introduction of early detection programs for high-risk patients. The shift in the primary detection of bronchogenic carcinoma from the central to the peripheral airways is another reason for the increase in their incidence. It is estimated that more than 1 million pulmonary nodules are detected worldwide each year, with the majority (90-95%) being benign in etiology (2). However, traditional diagnostic methods often lack the accuracy needed to distinguish between benign and malignant nodules, which often leads to unnecessary invasive procedures or, conversely, delays in initiating appropriate treatment. Below we summarize current knowledge about solitary pulmonary nodules, particularly with regard to their diagnosis and, in the future, treatment using an endobronchial approach.

Keywords: bronchoscopy, navigational methods, solitary pulmonary nodules.