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Chest x-ray showed subsegmental atelectases in the medial lung base. What does this mean?

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I have a CXR showing crowding of the pulmonary vasculature and some subsegmental atelectases in the medial right lung base. What does this mean in layman's terms?
Posted Wed, 20 Mar 2013 in Lung and Chest disorders
 
 
Answered by Dr. Gyanshankar Mishra 7 hours later
Hi,
Thanks for posting the query on XXXXXXX
After going through your query, I would like to comment the following:

1.You seem to have been diagnosed with asthma. You also have a history of recurrent chest xray shows sub segmental atelectasis of rt. middle lobe and crowded bronchovascular markings.

2. Consider your clinical history and xray findings, you need to get yourself evaluated in detail with a Pulmonologist.

3. Your inhalers and oral medications need to be titrated as per your pulmonary function tests.

4. Investigations that may be required are serum IgE (Total) and HRCT Scan thorax to rule out any central bronchiectasis which may be associated with such radiological findings. Most of the times a condition called ABPA(Allergic Bronchopulmonary Aspergillosis) needs to be ruled out in such cases.

5. Also smoking cessation is really important for you since it may lead to progressive deterioration of your lung functions which may then go on to become non responsive to inhalers if smoking is continued.

6. Also get 5 yearly pneumococcal vaccination and annual flu vaccination.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
Follow-up: Chest x-ray showed subsegmental atelectases in the medial lung base. What does this mean? 18 minutes later
Please explain the conditions listed in 4. Also , could this point to sacradosis?

 
 
Answered by Dr. Gyanshankar Mishra 25 minutes later
Hi,
Thanks for the follow up query. After going through your follow up query, I would like to comment the following:

1. ABPA:Allergic Bronchopulmonary Aspergillosis is one of the complications of long standing asthma. Central involvement on chest xray in the form of bronchiectasis and sometimes mucus plugging can lead to atelectasis findings radiologically. It is basically an allergic immune response to a fungus known as aspergillus fumigatus and needs to be recognised early in the course of disease.Diagnosis needs to be confirmed by HRCT Thorax, serum IgE levels (both total and specific for aspergillus Fumigatus) and serum IgG level of Aspergillus fumigatus. Treatment cornestone of this condition is oral steroids with inhalers.

2. Sarcoidosis could be a possibility but hilar adenopathy is common in sarcoid. You need to get your CT scan done to confirm this. Serum ACE (Angiotensin Converting Enzyme) levels need to be tested. If CT thorax shows a Hilar adenopathy as in most cases then a bronchoscopy guided TBNA (Transbronchial needle aspiration) can be done for confirmation of diagnosis. Also serum calcium and urinary calcium levels are supportive investigations.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by
 
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