PLEASE HELP REGARDING HRCT SCAN

[codybran]

Hi,
I was diagnosed by open lung biopsy in Nov 06 with Interstitial Lung Disease. Over the last two years my pulmonary Dr. has followed up with several CT scans including High Resolution. The findings on all of the CT scans has been pretty much the same. Ground-glass opacities in the lungs especially upper lungs and these are progressive from old high resolution exam. Bullous changes int the upper lungs. Correlate for COPD. Prominent axillary nodes. 3mm nodule left base. This was the findings on CT scan 12/07. I am concerned because I had a HRCT last week and the resluts state that there is no evidence of Interstitial lung disease and no ground glass opacity and no mention of COPD. I have a very severe non productive cough and shortness of breath I take 60mg of prednesone daily along with Advair and Arbuterol inhailers. I had a lung x-ray last week which showd that the bronchial tubes were all inflamed this is why I was sent for the CT scan. My concern is how can this new HRCT scan show all clear?? Is is possible to have had all these problems ongoing confirmed over 2 years and then all of a suden gone??. My lung biopsy was diagnosed at the Mayo Clinic. Do you think that there could be an error at the radiology center where I had the HRCT last week? I just don't understand how several CT scans are consistant and then all of a sudden completely normal. There is nothing more I would want then a good report but I am worried that this report is an error. I appreciate your opinon regarding the above. I still have all the same symptoms severe cough, shortness of breath. Is is possible for 6 CT scans to have mostly the same findings  and then this one to say completely clear???  Thank you so much for your response.
Liz

[National Jewish Health]

We regret that we must agree with your suspicion of the recent CT report of reversion to normality, especially resolution of the bullour changes.  Adding to this is the fact that your symptoms persist unabated.  In addition it is unlikely that your recent chest x-ray would be abnormal and the CT scan, normal.

However, interstitial lung disease (ILD) is a broad category that encompasses many pathologic forms of chronic lung disease some of these are steroid responsive and/or have a good prognosis.

You must consult with your pulmonary doctor and request his/her assistance to:

1. Contact the radiology department to determine if another person's CT interpretation was mis-identified as yours, or if there was an error in transcription.  The radiologist should pursue this with a re-comparison of all your CT scans.  Did your CT show a primarily ground glass appearance with no more than minimal reticulation?

2. Review the pathologist’s interpretation of your lung biopsy to determine if there was greater specificity to the interpretation that just ILD.  Did your biopsy show a purely cellular/organizing pneumonia pattern on biopsy?

3. Re-examine your lungs and repeat your pulmonary function tests (PFTs).

4. Provide his/her opinion on your type of ILD, whether resolution of the CT findings is possible or out of the question.

[codybran]

Just wanted to take a moment and thank you for your response. It has put my mind at ease knowing that you agree with my suspcions. I am scheduled to see my pulmonary doctor and will discuss my concerns. Again, thank you for response.
Regards,
Liz