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Pulmonary Fibrosis

Lobe Fibrosis and Volume Loss

01/05/2010

Question:

Hi, I am a 26 year old female and I was sent to take a chest x-ray by an insurance company because I would like to take out life insurance with them but when I was 13 or 14 years old, I had tuberculosis.

The x-ray results showed that there is right upper lobe fibrosis and volume loss. Elsewhere the lungs and pleural spaces appear normal and the heart size is normal. Should i be worried about the lobe fibrosis and volume loss? What does it mean?

Answer:

It is very common to have fibrosis (scar), bronchiectasis (enlarged airways), and volume loss from damage to the lung following tuberculosis. This most commonly occurs in the upper lobes of the lungs. The damage to the lung can result in some minor loss of lung function but most people are able to live normal lives. In this case, the fibrosis does not get steadily worse over time (unlike other interstitial lung diseases such as idiopathic pulmonary fibrosis, for example).

The damaged part of the lung is more prone to getting infected, however. Therefore, regular vaccination for influenza and pneumonia is advisable. Rarely, patients can get unusual infections in the damaged parts of the lung, such as fungal or mycobacterial infections. Therefore, patients with lung damage from previous tuberculosis should report new respiratory symptoms such as cough that does not go away in a few days, fevers, night sweats, etc. to their physician.

Rarely, patients can have more widespread damage throughout both lungs from previous tuberculosis resulting in diffuse (widespread) bronchiectasis. This is a very different condition than what you are describing and can be more serious with greater loss of lung function and limiting shortness of breath. However, if this was going to occur, it would have done so at the time of the initial infection with tuberculosis and not 12 years later.

For more information:

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Response by:

James N Allen, Jr, MD James N Allen, Jr, MD
Clinical Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University