The second most valuable radiologic criteria helpful to distinguish benign from malignant coin lesion is the stability of size over two years. Comparison with old x-rays is the only way to establish stability of size of a coin lesion over two years. Remind the patient about past hospitalizations, surgeries, emergency room visits, insurance and employment physicals, etc., to obtain past chest x-rays for comparison. Many times, this one piece of information often saves a lot of anxiety and unnecessary work-up and surgery.
Following a patient every three months with chest x-ray and carefully monitoring the size for a period of two years is permissible in selected cases.