Respiratory Disorders Expert Forum
what is focal pneumonitis?
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what is focal pneumonitis?

I had a cat scan done recently due to an abnormal chest x-ray. I became sick about 5 weeks ago and thought I had a bad case of bronchitis that was exacerbating my chronic asthma problems, but my breathing did not improve with treatment, which confused my doctor. I had severe shortness of breath (even talking made me breathless), and I have had a chronic  dry"wheezy" cough that has turned into a hacking cough.  My doctor felt I had pneumonia, but I never had symptoms of pneumonia (no fever, achiness, joint pain etc.) The only symptom I had was the shortness of breath, chronic cough, and some chest pain which I attributed to my coughing. I have a long history of severe allergies, and lung infections that go back to when I was a baby, and have been hospitalized numerous times for asthma in the past.
       Anyway, my question really has to do with the findings of my cat scan, and my lack of understanding it.
It says:
  1) no convincing evidence of mediastinal or hilar lymphadenopathy
  2) several scattered small focal infiltrates and/or superimposed nodular densities bilaterally, particularly in the both upper to mid lung field with the largest one noted in the right upper lung field measuring 1.1 to 1.2 cm in maximum diameter. The differential diagnosis would include focal pnuemonitis. However the possibility of neoplasm cannot be totally excluded
  3) essentially normal liver and adrenals and no evidence of pleural effusion
   I am scheduled to see the pulmonologist next week, but I am wondering if there is anything to worry about. Could this just mean I have scar tissue from past infections? Does it mean I have interstitial lung disease? I am wondering what tests the pulmonologist will want to do, and if I will be able to get my life back soon, and be able to go back to the gym. I am 42 years old, and I have never been a smoker due to my history. Could this be an undiagnosed problem from my childhood?
    Thanks for your time
  Laurie
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I am sorry but it is not possible for us to interpret these findings.  That would best be done by a chest or pulmonary radiologist.

Your history of allergies and lung infections is important as the findings, as described, are commonly seen as a residual of infection and unlikely to be a sign of neoplasm, commonly called cancer.  The absence of adenopathy and pleural effusions, is good news and the findings, as described, are not typical of interstitial lung disease (ILD).

You might want to ask your doctors if the diagnosis of pulmonary emboli has been excluded.  This would be worthy of consideration in the circumstance of severe breathlessness, not entirely explained by bronchitis or asthma.

You should also obtain all prior chest x-rays or CT scans for comparison with the current x-ray and CT.

Good luck.
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