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Respiratory Disorders (Expert Forum)
Emphysemic changes vs. emphysema
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Emphysemic changes vs. emphysema
by Eileen0422, Oct 20, 2006 12:00AM
My primary called me with the results of my chest CT and referred to "emphysemic changes", among other things. I obtained a copy of the report and the wording is "emphysema", not "emphysemic changes". What is the difference and why would he use that term as opposed to what the report stated? I am asymptomatic..the CT was done as a follow up to an incidental finding of nodule in the lower lung in 2004 during a hospital stay for a kidney infection.
Here are the impressions from the CT:
1. Biapical interstitial nodular prominence with right greater than left. Similar findings were reported on a prior CT chest dated 4/29/02. (Previously diagnosed in 2002 as Eosinophillic granuloma..quit smoking for a year and it reversed itself. Have since gone back to smoking.)
2. Subcentimeter nodule in the right middle lobe and subcentimeter nodule in the left lower lobe. Differential diagnosis includes infectious etiologies, or inflammatory etiologies. By report, these nodules were not evident on the prior exam. (Don't know if it matters, but I had a cold when the CT was taken)
3. Centrilobular emphysema.
4. 2.9 cm ovoid lesion in the lateral aspect of the right lobe of the liver. A similar finding was reported on the prior examination. This likely represents a benign finding. Further workup is recommended.
Is this a definitive diagnosis of emphysema? Primary doc did suggest I see the pulmonologist, but he seemed rather unconcerned in general...I really got the impression he was just covering his own a**, to be honest with you.
Thanks for your help
Eileen
Here are the impressions from the CT:
1. Biapical interstitial nodular prominence with right greater than left. Similar findings were reported on a prior CT chest dated 4/29/02. (Previously diagnosed in 2002 as Eosinophillic granuloma..quit smoking for a year and it reversed itself. Have since gone back to smoking.)
2. Subcentimeter nodule in the right middle lobe and subcentimeter nodule in the left lower lobe. Differential diagnosis includes infectious etiologies, or inflammatory etiologies. By report, these nodules were not evident on the prior exam. (Don't know if it matters, but I had a cold when the CT was taken)
3. Centrilobular emphysema.
4. 2.9 cm ovoid lesion in the lateral aspect of the right lobe of the liver. A similar finding was reported on the prior examination. This likely represents a benign finding. Further workup is recommended.
Is this a definitive diagnosis of emphysema? Primary doc did suggest I see the pulmonologist, but he seemed rather unconcerned in general...I really got the impression he was just covering his own a**, to be honest with you.
Thanks for your help
Eileen
Doctor's Answer
by National Jewish, Oct 26, 2006 12:00AM
, Oct 26, 2006 12:00AM
There is no medical difference between emphysema and emphysemic changes. It is impossible to say that a person has emphysema based upon the chest CT scan alone. This is not a definitive diagnosis of emphysema. It just means that some areas of emphysema are seen on your chest CT scan. So emphysemic changes is the most accurate term to use in describing your chest CT scan. These changes, which include centrilobular emphysema, are typically seen with emphysema. However, it is only possible to say that a person has emphysema based upon the results of pulmonary function tests (PFTs) along with the chest CT scan. The amount and significance of what is seen on your chest CT scan can easily be determined by PFTs. This is the gold standard for making the diagnosis of emphysema.
Please keep in mind that emphysema progresses 3 times faster in those who continue to smoke compared with those who never smoke again. Whether or not you are given the definitive diagnosis of emphysema, please consider never smoking again. Everyone in the United States has free access to telephonic counseling for quitting tobacco at Quitline (800) QUIT NOW. You may want to look at our giving up smoking information at http://www.nationaljewish.org/disease-info/wellness/smoking/index.aspx for ways to help you quit smoking. Also check with your doctor for other quit smoking resources in your area.
Please keep in mind that emphysema progresses 3 times faster in those who continue to smoke compared with those who never smoke again. Whether or not you are given the definitive diagnosis of emphysema, please consider never smoking again. Everyone in the United States has free access to telephonic counseling for quitting tobacco at Quitline (800) QUIT NOW. You may want to look at our giving up smoking information at http://www.nationaljewish.org/disease-info/wellness/smoking/index.aspx for ways to help you quit smoking. Also check with your doctor for other quit smoking resources in your area.
Get a full pulmonary function test, this will tell you more about the status of your emphysema. CT's are used to confirm Emphysema after abnormal PFT's.
Many have abnormal CT's suggestive of emphysema but live normal lives.
Rgds,
E.
Wish me luck with this insidious addiction and thanks again.
Eileen
Good luck to you.
I wish continued success to your husband!
Eileen
Don't ever smoke while you chew the nicotine gum. He did that one time and got real sick to the point where I thought I would've to call the ambulance. His face was grey as ashes and he had a headache out of this world.
Hang in there. You will make it! Don't get discouraged if you have a setback.
I am a non smoker and have had this on my chest CT!
I also smoked for some 30 years but I started chewing the nicotine gum and have not smoked in 6 years but still have real bad breathing problems very short of breath ,smoking is the worse thing we can ever do to our body I truly believe that and it is soo addictive