What Does This Mean?

[maddie1851]

Sorry, I wasn't sure where to post this.  I am totally freaking out and my doctor is blowing me off with "don't worry yet".  I had a ct scan with contrast which they want to repeat in 3 months.  

The findings:  The lungs are well expanded.  Mild diffuse interstitial prominence is noted.  This is non-specific but could be related to chronic or acute process.  At the lung apices, there are speculated parenchymal opacities which appear to be pleural based.  Without benefit of previous examinations, the chronicity cannot be determined.  While the findings may be related to scarring, a follow up Ct of the chest in three months is recommended.  No effusions are seen.  ..........................  Limited evaluation through the upper abdomen demonstrates a possible tiny, less then 5 mm, low density lesion within the right lobe of the liver near the dome of the diaphragm which is too small to further characterize........................

Impression:  Pleural-based spiculated parenchymal opacities involving both upper lobes as described.

What does all this mean?  I don't think I can wait 3 months to have some idea of what I might be dealing with.

[National Jewish Health]

That the findings are in both lungs is strong evidence against these "opacities" being tumors.  They could, however, be indicative of infection, active or inactive, and the most likely infections would be 2 that are quite common tuberculosis (TB) or a fungus called histoplasmosis.  The description of the appearance of the opacities is more consistent with inactive disease, especially the statement that "the findings may be related to scarring”.

The other possibility, given the statement that the shadows "appear to be pleural based" is that the scarring was caused by inhalation, usually occupational, of inorganic dust, for example asbestos or silica but the localization to the upper portions of the lungs would be most unusual with these dusts.

If you are coughing-up sputum, it should be cultured for TB.  A TB skin test and/or blood test for TB might also be appropriate.

Otherwise, the advice to wait and repeat the CT scan in 3 months is sound and you should follow that advice.

[maddie1851]

Thank you so much for taking the time to explain and easing my mind.  I should have mentioned that the ct scan was done after I had requested a chest x-ray purely because I had stopped smoking and wanted a base line for the future.  They recommended the ct scan after seeing what was called a nodule on the x-ray.  I haven't had a cough or any other symptoms.  Up until about 5 years ago, I used to get what the doc would call walking pneumonia annually and an accompanying horrible cough that would last weeks and felt like it started in my toes.  After a pneumonia vaccination 5 year ago, I haven't had so much as a cold since.  I quit smoking 7 months ago but smoked for 30 years, about one pack/day.