Lung blebs, also known as emphysematous bullae, is known to preferentially occur in young, thin males, and cause the lung alveoli to distend to form large pouches. These may occasionally rupture and cause air to leak out into the pleura, causing respiratory difficulty.
Please consult a pulmonologist, who will review your CT thorax films and advise appropriate treatment. Avoid smoking.
All the best, and God Bless!
I am a London, UK-based, 51 yo male and heavy smoker of 35 years duration. (I have now stopped smoking and it is 15 days since I stopped.)
For 3-4 weeks I had been suffering a very bad dry cough accompanied by real tightness high in the chest, wheezing and breathlessness. This was at its worse at night, and frequently woke me up in the early hours when I had to stand up or sit upright to breathe.
There was no release of phlegm attached to these symptoms.
So I visited my local Doctor (General Practitioner - GP) who - based on my age, smoking history (equivalent to 50+ pack years), symptoms, and physical examination - suspected Chronic Obstructive Pulmonary Disease and probably caused by Emphysema brought on by smoking. I have no history of Bronchitis or Asthma.
She sent me to my local Hospital that same day for a Chest XRay and was due to see her a week later. In the meantime she prescribed me a BronchoDilator Reliever to manage symptoms.
The next day she phoned me to ask me to come to her Surgery to discuss the CXR results which she had already received.
The Consultant Radiologist (CR) reported an area showing a mass in the upper right, and a small area of calcification in the bottom left.
On that basis the CR recommended that my GP fax an Urgent Referral for Suspect Lung Cancer to the Hospital, which she did.
I was seen 5 days later by a Specialist Registrar (SpR) in the clinic of the Lead Clinician for Lung Cancer in the Respiratory Medicine department of my local NHS hospital.
He went through my symptoms with me and confirmed clearly with me that I had had no phlegm that had blood in it or was dark brown in colour. He gave me a thorough physical examination of significant duration. He then went through the CXR with me showing me the upper right area that he considered to be enlarged lymph nodes. He then sent me for extensive Lung Function Tests that were Spirometry and ones in an airtight cubicle - much like a shower cubicle - that were done pre and post use of a BronchoDilator Reliever and lasted about 1 hour.
I then saw the SpR again and he said the Lung Function tests were very good, such that he felt they were little different to what he would expect from a non-smoker of my age who did not suffer with Asthma, and that the post BronchoDilator use tests showed no difference which indicated I was not an Asthmatic.
He then concluded by saying he was very happy with his examination of me and the Lung Function tests, and that he would not recommend prescribing any treatment and that I could continue to use the Salbutamol Reliever as and when I felt I needed it.
He informed me I had already been scheduled for a contrast-CT Scan of the chest and abdomen some days later and, dependent on the results of that they would carry out a Bronchoscopy or Fine Needle Aspiration if the CT Scan results warranted it.
I have now had a letter from the SpR on the contrast-CT Scan results as follows:
"This showed merely some small enlargement of the lymph nodes in your chest but did not show any significant worrying lung lesion. We therefore do not need to proceed to a bronchoscopy or CT guided biopsy at this time but we shall send you another clinic appointment shortly to see how you are getting on."
I have also received the follow up appointment for December 2009.
What I wanted to ask - as it will be nearly 3 months until this next appointment - as I am now not suffering *any* of the original symptoms (no coughing, no breathlessness, no wheezing and no tight chest) would it be reasonable and safe to assume that the those lymph nodes are probably no longer enlarged? Since I have read that enlarged lymph nodes deep in the chest are known to cause breathlessness, wheezing, coughing and tightness if I am no longer suffering any of that I'm probably no longer suffering the enlarged nodes either?
Also, when the SpR says the CT Scan did "not show any significant worrying lung lesion." does that mean it may still have shown some lung lesion but just nothing severe? Or is that me interpreting the SpR's cautious words too literally?
Also, should I question why the SpR has made no comment on the Consultant Radiologist's report on the original CXR relating to an area of calcification?
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