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Shadow Found on Lung Scan
What It Means & What Happens Next

Being told there is a shadow on your lung scan is worrying — but the great majority of shadows found this way are completely benign. What matters is getting a proper specialist review so you know clearly what you are dealing with. Dr Lawrence Okiror, Consultant Thoracic and Robotic Surgeon (GMC 6150382), reviews CT scans personally and gives a clear answer at the first appointment: either reassurance, a monitoring plan, or — where needed — a path to treatment. Where cancer is found, every case is discussed with a specialist team before any decision is made. Private appointments within 2–3 days.

Last reviewed: April 2026 · Dr Lawrence Okiror FRCS(CTh) FRCSEd(CTh) · GMC 6150382

Most Are Benign

The vast majority of shadows found on lung scans are benign — old infection, scar tissue, or harmless calcification. Most patients leave the first appointment with reassurance and a clear monitoring plan, not a diagnosis of cancer.

Early Assessment Matters

Where a shadow does turn out to be cancer, finding it early — when it is still small — means significantly more treatment options, including keyhole surgery and targeted therapies. A proper assessment is in your interest whatever the result turns out to be.

A Clear Answer at Appointment One

Dr Okiror reviews the actual scan images personally using a validated scoring tool. By the end of the first appointment, most patients have one of three clear plans: a surveillance schedule, a biopsy, or surgery. No one leaves without knowing what happens next.

Can a shadow appear on a scan even if I feel completely well?

Yes — and this is increasingly common. Most lung shadows are found incidentally, during a scan done for an entirely different reason: a back injury, a cardiac assessment, a chest infection. Because many early lung cancers produce no symptoms at all, an incidental finding is often the best possible scenario. It means you have found it early, while treatment options are at their widest.

What will Dr Okiror look at when reviewing my scan?

Dr Okiror reviews the actual CT images personally — not just the written report. He uses a validated risk scoring tool called the Brock score, which looks at the size, shape, and type of shadow, its location in the lung, and your personal risk factors including age and smoking history. This gives a specific, evidence-based picture of what the shadow is likely to be.

What are the three possible outcomes?

Most patients leave with one of three clear plans. First: the shadow is very likely benign — a monitoring schedule is agreed, with a repeat CT at a set interval to confirm it stays stable. Second: a biopsy is needed to get a tissue sample and confirm what the shadow is. Third: the shadow is highly likely to be cancer and surgery is the right next step. Dr Okiror explains which applies and why.

How quickly will I get a clear answer at the first appointment?

In the majority of cases, the answer is: at the appointment itself. Dr Okiror reviews the imaging in the consultation room, applies the Brock score in real time, and communicates a clear plan before you leave. Most patients do not go home uncertain. Where a biopsy is the next step, this is arranged promptly — typically within days, not weeks.

The Brock Score
A Plain-Language Explanation

Rather than rely on a clinical impression alone, Dr Okiror uses a validated scoring tool to assess every lung shadow. Here is what it looks at and what the result means for you.

What the score looks at

  • The size of the shadow — larger nodules carry higher risk
  • Whether it is solid, or partly solid with a hazy appearance
  • Where in the lung it sits — upper lobe nodules have higher risk
  • Whether the edges are smooth or irregular (spiculated)
  • Your age, sex, and smoking history
  • Any family history of lung cancer

What the result means

  • LowVery likely benign. A CT scan at 1 year confirms it is stable. Most patients in this group are reassured and discharged.
  • MediumNeeds closer monitoring. CT at 3 months, then at 1 year. If stable throughout, it is almost certainly benign.
  • HigherWarrants a tissue sample or surgery. Either a biopsy via bronchoscopy or, where the scan is strongly suggestive, direct surgical removal.
  • GrowthAny nodule that grows on a repeat scan is escalated, regardless of initial score.

It is worth knowing that a normal chest X-ray does not rule out a nodule. CT scanning is more sensitive, and many nodules are only visible on CT. If you have been told your chest X-ray was normal but something has since been found on CT, that is not a contradiction — it is simply that CT picks up smaller changes.

Finding It Early
Makes a Real Difference

If a shadow turns out to be an early lung cancer, finding it at this stage — before it has grown or spread — means the most treatment options are available. This includes keyhole surgery to remove it completely, targeted therapies matched to the specific genetic type of the cancer, and a much better chance of complete treatment.

This is one of the reasons a proper assessment is worth having even when the likely answer is reassuring — because the small proportion of patients who do have cancer benefit enormously from finding it at this stage.

A team decision, every time

Every cancer case is discussed with a multidisciplinary team of specialist oncologists at the London Bridge Hospital chest MDT, which Dr Okiror attends fortnightly. Where a case needs urgent discussion, Dr Okiror has direct access to specialist colleagues outside the formal MDT — so no patient waits a fortnight for a decision that cannot wait. No treatment plan is made by a single doctor alone.

If surgery is needed

Where surgery is the right option, Dr Okiror performs it using keyhole robotic or VATS technique in the vast majority of cases — smaller incisions, faster recovery, and less disruption to surrounding tissue. Over 80% of operations at GSTT are performed by robotic or keyhole technique. Lung nodule surgery →

Questions About
Shadows on Lung Scans

Questions most commonly asked by patients and family members after being told a shadow was found on a lung scan.

Book an Assessment →

Or call Jo Mitchelson:
020 7952 2882

A shadow was found on my lung scan. Should I be worried?
It is natural to feel anxious, but the great majority of shadows found on lung scans are benign — old infection, scar tissue, or harmless calcification. What matters is getting a proper specialist review so you know clearly which category applies to you. Most patients leave the first appointment with reassurance and a clear plan, not a diagnosis of cancer.
What does the assessment involve?
Dr Okiror reviews the actual CT scan images personally and uses a validated risk scoring tool called the Brock score to assess what the shadow is likely to be. The score takes into account the size, shape, location, and type of the shadow, as well as personal factors such as age and smoking history. By the end of the first appointment, most patients have a clear plan: surveillance, biopsy, or surgery.
What if the shadow turns out to be nothing serious?
This is the most common outcome. Where the shadow is assessed as very likely benign, Dr Okiror explains why and agrees a monitoring plan — usually a repeat CT scan at a specific interval to confirm the shadow stays stable. Nodules that remain stable over time are confidently discharged. The reassurance is meaningful because it is based on evidence and a proper assessment, not guesswork.
If cancer is found, what happens?
Every cancer case is discussed with a multidisciplinary team of specialist oncologists at the London Bridge Hospital chest MDT, which Dr Okiror attends fortnightly. Where urgent discussion is needed, Dr Okiror has direct access to specialist colleagues between MDT meetings. Finding cancer early — when it is still small — means more treatment options, including keyhole surgery and targeted therapies.
Can a nodule be investigated without surgery?
Yes. Where a tissue sample is needed from a nodule in the outer part of the lung, ION robotic bronchoscopy at London Bridge Hospital can reach the nodule and take a sample without any surgical incision. London Bridge was the first centre in Europe to offer this procedure in routine clinical practice outside NHS trials.
Do I need a GP referral to be seen?
No. You can contact the practice directly and be seen within 2–3 days at London Bridge Hospital. Bring any existing imaging — chest X-ray or CT scan — as this allows a fully informed assessment at the first appointment. New consultations from £250. Most major insurers accepted. Second opinions also available.

Most shadows are benign.
But you deserve to know for certain.

Private appointments at London Bridge Hospital within 2–3 days. Bring your existing scan. Dr Okiror will review it personally and give you a clear answer — and a clear plan — at the first appointment.

Book an Assessment → Nodule Precision Pathway

Jo Mitchelson, Private PA  · 020 7952 2882 · pa@lungsurgeon.co.uk

Guy’s and St Thomas’ ranked #1 and #2 in the UK · London Bridge Hospital #10 · Newsweek World’s Best Hospitals 2026

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