Subsegmental atelectasis vs fibrosis what does it mean

[mariaclara]

Before my thyroidectomy because of papillary thyroid carcinoma, my xray result :
     There is a linear density in the left lower lung field
      The heart is not enlarge
      Both costophrenic sulci and hemidiaphragm are intact
      Soft tissues and osseus structures are unremarkable

       Impression:  Subsegmental atelectasis VS fibrosis, left lower lung field

  What does it mean.  The doctors did not discuss it with me. I'm concern.  I'm 5 wks post operation
   and i will undergo radioactive iodene treatment 150 mci on march 10 and post theraphy scan
   a week after.  Is the subsegmental atelectasis means my CA is now spread in my lower in left lower lung field? I'm worried

[Arnold_Cruz]

Thanks for the information about this bi basal subsegmental atelectasis/fibrosis. I thought it was the same with pulmonary fibrosis...

[gsaikin]

Could one of you moderators take the first two posts by me away?  I was trying to make changes and I ended up posting three times :/  OUCH!  ::sigh::  oh well...

[gsaikin]

It started in Sept. 04 - had an EGD, then the next day, woke up seriously ill, high fever and vomiting.  An ER visit revealed spesis and pneumonia, so I was admitted and treated.  There begain an 8 month revolving door - 1 visit/permonth for pneumonia treated with antibiotics and breathing treatments.  Then, for six months nothing - after a bronch which 'cleared out a bunch of gunk".  Between Oct '05 and Feb. '06, there were a few problems, but as of 2/06, I sent my O2 equipment back to the DME provider until March, 2007, when whatever hit me in '05 returned with a vengeance and I returned to being a patient at least once/month (my guess is I've been hospitalized around 50 times now).  Each time, my lungs got worse and each time we tried to figure out what was wrong.  I'd been  a smoker (quit in 2003) so the doc at first, naturally dx'd COPD until the last PFT not only showed dramatic changes in function (most functions dropped almost 50% or more) but also showed restrictive rather than obstructive changes more notably my my DLco dropped to at least 20% (they cannot do it now - my FEV is too low, they say to measure it).

I've been on the Vent two times now since 2004, both times were a bit iffy - the last time was nasty.  We'd gotten to church (I remember part of this - my daughter tells me the rest) and I yelled "call 911, I cannot breathe" then passed out.  Daughter performed CPR, someone called 911 and by the time the paramedics got there, I had almost coded (doctor said I DID code).  They externally paced me enroute to the hospital (and bagged me too) then put me on a vent upon arrival.  (have to start wearing old clothes to church - if they have to keep cutting the good ones off!  LOL!

I've been in due to 'co2 narcosis' (one of the Vent visits), fluid overload, and the last time, cellulitis (at least it wasn't lung!).  My stamina now is totally shot.  I am so very weak, it's hard for me to walk from livingroom to bathroom, and trust me, that's NOT very far! I'm on 4 lpm continuous 24/7 and sometimes 5 lpm intermittent when I go out.  After a while out - say a few hours, my sats might start to waver into the low 90's and sometimes the high 80's (87-90 say)

The 2nd opinion doc calls it 'multifactorial pulmonary fibrosis' - I know you can't dx over the phone and/or see what I'm talking about, but I've been scanning in my medical records and if you'd like some I'd be willing to get them to you electronically - either a CD or whatever.

I don't think it's cancer - that was the doc's first thought when I was his new patient, given my multiple pneumonias, etc.  I just wish they'd thought of a biopsy earlier before I was too far gone for it.  You know, that's a more subtle danger of smoking - being put into a cubbyhole by docs and only appearing outside of it IF something happens that makes them say "oh, it can't be that!" - like my plummeting PFT's, and by that time, it could be too late for definitive tests like biopsies, etc.

[gsaikin]

It started in Sept. 04 - had an EGD, then the next day, woke up seriously ill, high fever and vomiting.  An ER visit revealed spesis and pneumonia, so I was admitted and treated.  There begain an 8 month revolving door - 1 visit/permonth for pneumonia treated with antibiotics and breathing treatments.  Then, for six months nothing - after a bronch which 'cleared out a bunch of gunk".  Between Oct '05 and Feb. '06, there were a few problems, but as of 2/06, I sent my O2 equipment back to the DME provider until March, 2007, when whatever hit me in '05 returned with a vengeance and I returned to being a patient at least once/month (my guess is I've been hospitalized around 50 times now).  Each time, my lungs got worse and each time we tried to figure out what was wrong.  I'd been  a smoker (quit in 2003) so the doc at first, naturally dx'd COPD until the last PFT not only showed dramatic changes in function (most functions dropped almost 50% or more) but also showed restrictive rather than obstructive changes more notably my my DLco dropped to at least 20% (they cannot do it now - my FEV is too low, they say to measure it).

I've been on the Vent two times now since 2004, both times were a bit iffy - the last time was nasty.  We'd gotten to church (I remember part of this - my daughter tells me the rest) and I yelled "call 911, I cannot breathe" then passed out.  Daughter performed CPR, someone called 911 and by the time the paramedics got there, I had almost coded (doctor said I DID code).  They externally paced me enroute to the hospital (and bagged me too) then put me on a vent upon arrival.  (have to start wearing old clothes to church - if they have to keep cutting the good ones off!  LOL!

I've been in due to 'co2 narcosis' (one of the Vent visits), fluid overload, and the last time, cellulitis (at least it wasn't lung!).  My stamina now is totally shot.  I am so very weak, it's hard for me to walk from livingroom to bathroom, and trust me, that's NOT very far!  Back in 2008, I had three hospital stays back to back to back, and ended up in a rehab/nursing home for a few weeks - both until I'd gotten my 'sea legs' back and we had to move out of our mobile home due to the plethora of gas pilot lights and the layout (not very good for a wheelchair - those things are built like box cars!  Scrambled and found two one-bedroom apartments low income no waiting (a small miracle) period.  It wouldn't be hard for me to want to come back - I grew up in Ft. Collins, so Colorado's my home state!  Graduated from Loveland High. Why here?  How about country kid wants to go to big city (Chicago).  I moved from Chicago to Detroit area for work after being laid off from three companies that closed under me in Illinois back in the late 80's and early 90's.  

A second opinion with Dr. Flaherty at University of Michigan brought forth a diagnosis of 'multifactorial pulmonary fibrosis' - they tell me I'm 'too far gone' for a biopsy - I wouldn't survive one.  I can electronically send you the records if you like - say six months of discharge summaries plus the 2nd opinion from UMICH.  ???  Getting out there might be impossible - oh, we have the van and so on, just not the $'s.  I MIGHT be able to stay with a friend out there for a few days but it's the drive out there (Knowing areas of CO I'm going to be in like I do, I'd drive) and the price of gas today that has me doubtful.  Heck, even a 'short' trip to Chicago (350 miles) from here seems light years away - I have to get a motel room - my daughter's house isn't power-chair friendly.

Please let me know!  Thanks!

[gsaikin]

It started in Sept. 04 - had an EGD, then the next day, woke up seriously ill, high fever and vomiting.  An ER visit revealed spesis and pneumonia, so I was admitted and treated.  There begain an 8 month revolving door - 1 visit/permonth for pneumonia treated with antibiotics and breathing treatments.  Then, for six months nothing - after a bronch which 'cleared out a bunch of gunk".  Between Oct '05 and Feb. '06, there were a few problems, but as of 2/06, I shttp://www.medhelp.org/posts/new/459068#ent my O2 equipment back to the DME provider until March, 2007, when whatever hit me in '05 returned with a vengeance and I returned to being a patient at least once/month (my guess is I've been hospitalized around 50 times now).  Each time, my lungsz got worse and each time we tried to figure out what was wrong.  I'd been  a smoker (quit in 2003) so the doc at first, naturally dx'd COPD until the last PFT not only showed dramatic changes in function (most functions dropped almost 50% or more) but also showed restrictive rather than obstructive changes more notably my my DLco dropped to at least 20% (they cannot do it now - my FEV is too low, they say to measure it).

I've been on the Vent two times now since 2004, both times were a bit iffy - the last time was nasty.  We'd gotten to church (I remember part of this - my daughter tells me the rest) and I yelled "call 911, I cannot breathe" then passed out.  Daughter performed CPR, someone called 911 and by the time the paramedics got there, I had almost coded (doctor said I DID code).  They externally paced me enroute to the hospital (and bagged me too) then put me on a vent upon arrival.  (have to start wearing old clothes to church - if they have to keep cutting the good ones off!  LOL!

I've been in due to 'co2 narcosis' (one of the Vent visits), fluid overload, and the last time, cellulitis (at least it wasn't lung!).  My stamina now is totally shot.  I am so very weak, it's hard for me to walk from livingroom to bathroom, and trust me, that's NOT very far!  Back in 2008, I had three hospital stays back to back to back, and ended up in a rehab/nursing home for a few weeks - both until I'd gotten my 'sea legs' back and we had to move out of our mobile home due to the plethora of gas pilot lights and the layout (not very good for a wheelchair - those things are built like box cars!  Scrambled and found two one-bedroom apartments low income no waiting (a small miracle) period.  It wouldn't be hard for me to want to come back - I grew up in Ft. Collins, so Colorado's my home state!  Graduated from Loveland High. Why here?  How about country kid wants to go to big city (Chicago).  I moved from Chicago to Detroit area for work after being laid off from three companies that closed under me in Illinois back in the late 80's and early 90's.  

A second opinion with Dr. Flaherty at University of Michigan brought forth a diagnosis of 'multifactorial pulmonary fibrosis' - they tell me I'm 'too far gone' for a biopsy - I wouldn't survive one.  I can electronically send you the records if you like - say six months of discharge summaries plus the 2nd opinion from UMICH.  ???  Getting out there might be impossible - oh, we have the van and so on, just not the $'s.  I MIGHT be able to stay with a friend out there for a few days but it's the drive out there (Knowing areas of CO I'm going to be in like I do, I'd drive) and the price of gas today that has me doubtful.  Heck, even a 'short' trip to Chicago (350 miles) from here seems light years away - I have to get a motel room - my daughter's house isn't power-chair friendly.

Please let me know!  Thanks!

[HeinrikMD]

Hi,
The X-ray finding signifies an opacity. Which may only be a scar (fibrosis- probably due to a previous infection) or small areas of collapsed lung (subsegmental atelectasis – this can be due to a previous infection or simply because you did not breathe deeply enough when the X-ray was taken).
At any rate, even if there is cancer in the lung this will show up in the radioiodine scan. If it is indeed present in the radioiodine scan, you will get a chance to evaluate it again during the post therapy scan in which it should have resolved.
Stay positive.