I had some minor back pain when breathing and went to the doctor who suggested a CT scan of my lungs. I am concerned and confused by the results. the part of concern states: Incidental note is made of mild apical to parenchymal scarring with probable subpleural bullae though no evidence of pneumothorax.
the doctor briefly told me that he thinks I have pleurisy and to just take advil and let it run its course. I am still upset about these results. At the bottom of the report it says: minimal bilateral apical pleural-parenchymal scarring and tiny subpleural bullae though no pneumothorax. there is no evidence of airspace consolidation or pulmonary embolus.
The part I am most concerned about is the subpleural bullae. the doctor did not mention them and I can not find anything online. Can someone please explain this to me? I am home today and pretty upset about this report.
The apical scarring is just that – a scar, almost certainly a residual of an infection in that part of your lung, sometime in the past. As a scar, it is not an indication of active disease. The most common cause of such scarring is tuberculosis (TB), which is currently inactive.
The sub-pleural bullae are cystic, meaning bubble-like, lesions on the surface of your lung that is in direct contact with the chest wall. These have no effect on your lung function or lung capacity. If you can imagine, these are like the small bubbles that one sees on a balloon or an inner-tube. As such, they can spontaneously rupture, resulting in air leakage into your chest and lung collapse, called a pneumothorax. That leakage and collapse is often associated with pain, called pleurisy. A very small leakage, no longer visible when the CT scan was done, may have been the cause of your pain.
Yes, these bullae do increase your risk of having a spontaneous pneumothorax, as described above, but are otherwise of no significance.
I suggest, however, that you seek consultation with a lung specialist, also known as a pulmonologist, to confirm these findings of bullae and assess your risk of a pneumothorax. It is highly likely that no intervention will be recommended, at this time. Should you ultimately have one or more pneumothoraces, these are easily treated and actions can be taken that will prevent their recurrence.
The second reason to see the lung specialist is to determine if the apical scarring warrants consideration of your taking an anti-TB medicine for a few months, as a preventative.
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