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What Causes Chest Congestion And Lung Irritation?
Question: Hi,
39 year old male, occupation tugboat engineer with cumene chemical barge lots of exposure to diesel exhaust/fuel fumes. My left lung and breathing had been bothering me for the last six months. I work 21 days on and 21 days off-at first the chest congestion and lung irritation would subside after 3 days home then 5 days then now 6 months later took my 3 weeks home. So I went to gp sent to pulmonary, said I basically had an enivronmental non infected bronchitis probably from all the exhaust fumes etc. Then I had a ct scan which read: used 1.25 mm slice thickness without contrast.
Findings: Soft tissue window imaging showed no pathologic mediastinal adenopathy. A triangular area of soft tissue density in the anterior mediastinum is consistent with residual thymic tissue. Lung window imaging shows ill defined area of infiltrate or scarring in the middle lobe anteromedially. No other evidence for infiltrate. There is no evidence for fibrosis or bronchiectosis. There is an indeterminate noncalcified 5-mm nodule in the right upper lobe anteriorly. No other nodules identified. No effusion.
I am really concerned lung irritated and now this. dont want to go back to work in fear of this and making it worse. Can a biospy be done? What is the potential for cancer? please help? Also my mother in law from the philliphines that I was around 4 years ago had active tb but I get tested annually for my job and all negative. Want to do something while I have good insurance was thinking about a career change. One plumonary said wait year for followup ct-too long for me and my nerves.
39 year old male, occupation tugboat engineer with cumene chemical barge lots of exposure to diesel exhaust/fuel fumes. My left lung and breathing had been bothering me for the last six months. I work 21 days on and 21 days off-at first the chest congestion and lung irritation would subside after 3 days home then 5 days then now 6 months later took my 3 weeks home. So I went to gp sent to pulmonary, said I basically had an enivronmental non infected bronchitis probably from all the exhaust fumes etc. Then I had a ct scan which read: used 1.25 mm slice thickness without contrast.
Findings: Soft tissue window imaging showed no pathologic mediastinal adenopathy. A triangular area of soft tissue density in the anterior mediastinum is consistent with residual thymic tissue. Lung window imaging shows ill defined area of infiltrate or scarring in the middle lobe anteromedially. No other evidence for infiltrate. There is no evidence for fibrosis or bronchiectosis. There is an indeterminate noncalcified 5-mm nodule in the right upper lobe anteriorly. No other nodules identified. No effusion.
I am really concerned lung irritated and now this. dont want to go back to work in fear of this and making it worse. Can a biospy be done? What is the potential for cancer? please help? Also my mother in law from the philliphines that I was around 4 years ago had active tb but I get tested annually for my job and all negative. Want to do something while I have good insurance was thinking about a career change. One plumonary said wait year for followup ct-too long for me and my nerves.
Brief Answer:
the idea of changing job is best
Detailed Answer:
Hi dear,
As your pulmonologist said it to be environmental bronchitis, I totally agree with him. The history given by you indicates towards allergic asthma like symptoms that are exacerbated by a particular environment i.e. your job place. These symptoms decrease when you leave the job place. This is a common problem.
I would not consider this to be related to cancer because in cancer symptoms don't decrease without treatment.
NMow what you can do is important. the options are---
1. change the environment ie. job.
2. use drugs like anti allergic and bronchodilators.
3. use breathing masks with filters till u find a new job.
4. stand near a window while on job.
5. increase the movement of air at ur job place.
Eegarding the small nodule 5mm in lung, don't worry much. The other pulmonologist said rightly we should follow that with yearly CT scan. No other modality can address that nodule - its very small to biopsy or for FNAC and finally unlikely to be cancerous.
Regards
the idea of changing job is best
Detailed Answer:
Hi dear,
As your pulmonologist said it to be environmental bronchitis, I totally agree with him. The history given by you indicates towards allergic asthma like symptoms that are exacerbated by a particular environment i.e. your job place. These symptoms decrease when you leave the job place. This is a common problem.
I would not consider this to be related to cancer because in cancer symptoms don't decrease without treatment.
NMow what you can do is important. the options are---
1. change the environment ie. job.
2. use drugs like anti allergic and bronchodilators.
3. use breathing masks with filters till u find a new job.
4. stand near a window while on job.
5. increase the movement of air at ur job place.
Eegarding the small nodule 5mm in lung, don't worry much. The other pulmonologist said rightly we should follow that with yearly CT scan. No other modality can address that nodule - its very small to biopsy or for FNAC and finally unlikely to be cancerous.
Regards
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Above answer was peer-reviewed by :
Dr. Prasad
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