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Lung diseases

Multiple Chronic Lung Problems

03/15/2011

Question:

Hi, hope you can help. I`m very confused, and getting very stressed! I`m a 56 year old female, with a 42 pack/year smoking history (I stopped at the sight of my X ray, six months ago). About 8 months ago, I had a bad chest infection, which developed into a serious pneumonia, requiring 3 weeks hospitalisation. A CT done at that time showed a 2.7cm lesion, with a cavity, in the anterior region of the RUL. A PET scan showed significant uptake in the lesion, but nowhere else. As this could signify inflammatory process, or malignancy, it was decided to wait three months. 

Ten days ago, I had a follow-up CT. I asked the radiologist for a run-through of her findings (as my pulmonologist does not explain everything to me, and does not rush with appointments). She said there was considerable scarring, bronchiectasis, and emphysema (her words being, the lung in the affected region was practically destroyed). She could not comment on the lesion, as my case-notes with previous results had not arrived with her! But , looking at it myself, it looked to be slightly improved to my untrained eye, and I could not see the cavity. 

My question is, are any of these problems likely to resolve, or are they all progressive? Hope you can help me, as I`ve been worried sick for months now, and it just seems to get more complicated with each investigation. Thanks.

Answer:

As you can imagine, it is very difficult to comment about CT and PET results without being able to review the images. People can be left with scarring from pneumonia, and this can lead to continued symptoms. People can also have scarring without any symptoms or problems and scarring can resolve over time. Only the health professional who ordered the tests should interpret your results as the answer to your questions is best provided in the context of other information that your health care provider has available. I would suggest that you contact your own health care provider to answer this question for you. If your physician is unable to help you understand these issues, you should get a second opinion.

Best wishes.

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Response by:

James M O'Brien, Jr, MD James M O'Brien, Jr, MD
Former Associate Professor
Pulmonary and Critical Care Medicine
College of Medicine
The Ohio State University