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Lung diseases

Lung infiltrates

01/12/2007

Question:

i have been diagnosed with lung infiltrates since Sept. In Dec. a pulmonologist did a bronchoscopy & seemed to rule out cancer (I have a history of breast cancer). He seemed to think it was connected with GERD. He had me schedule an endoscopy which I am having today. Then yesterday one of his assistants called and said a Dec. chest x ray showed a new different lung infiltrate & I must have a CAT scan next week. I don`t even know what a lung infiltrate is, much less what could have caused it. I haven`t smoked in 24 years, but have had breast cancer, MRSA, bowel blockages, pneumonia several times and C Dif in the past 2 1/2 years. Can you help me understand what is going on?

Answer:

An infiltrate is an opacification that is present on chest imaging studies such as a chest x-ray or CT scan.  The opacification is caused by the presence of any substance that is denser than air that is present within the lung parenchyma.  Possible causes of infiltrates or opacifications include cells such as cancerous cells, infection such as pneumonia, fluid such as congestive heart failure, blood such as pulmonary hemorrhage, inflammation such as cryptogenic organizing pneumonia.

If the infiltrates persist and a diagnosis can not be determined by imaging techniques or sputum studies, a lung biopsy may be required.  A biopsy can be performed by bronchoscopy although these biopsies are smaller and subject to sampling errors.  Surgical biopsies are usually definitive.

It will be very important to review the results of the studies that have been performed with your physicians and formulate a plan to obtain a definitive diagnosis.

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Response by:

Ralph   Panos, MD Ralph Panos, MD
Associate Professor
College of Medicine
University of Cincinnati