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What Does "fibro-infiltrative Shadows Suggestive Of Koch's Infections" Mean?
Question: Hi Doctors, I had suffered from Pulmonory TB around 8 year backs and since then I do not have any problem. However when I have applied for term insurance last week and I was asked for Chest X-Ray and based on that insurance company has declined my proposal. Enclosed is X-Report and in this please explain me 2 bold line and also let me know if there is anything serious for my health. thanks
Brief Answer:
No reports attached
Detailed Answer:
Hi, thanks for posting your concern in the HCM.
I haven't found any report attached along-with. There must be some network/server problem during attaching the same. Therefore, please attach the intended report in your follow up query to this answer at the earliest.
However, after attack of pulmonary tuberculosis, some fibrotic changes may remain in the lung, which often looks like interstitial lung disease. In case you really don't have a problem, I think they didn't give you the insurance policy because of that apparent abnormality in X-ray. And I should clearly tell you that these apparent abnormality remains there even after you get cured. But, that is truly difficult to differentiate from an existing lung disease from an X-ray.
I shall be able to give you a more comprehensive answer, once you get the report attached here in the follow up query.
For the time being, I can definitely understand your embarrassment and please don't worry of your health if you are aymptomatic.
Regards,
Dr. Kaushik
No reports attached
Detailed Answer:
Hi, thanks for posting your concern in the HCM.
I haven't found any report attached along-with. There must be some network/server problem during attaching the same. Therefore, please attach the intended report in your follow up query to this answer at the earliest.
However, after attack of pulmonary tuberculosis, some fibrotic changes may remain in the lung, which often looks like interstitial lung disease. In case you really don't have a problem, I think they didn't give you the insurance policy because of that apparent abnormality in X-ray. And I should clearly tell you that these apparent abnormality remains there even after you get cured. But, that is truly difficult to differentiate from an existing lung disease from an X-ray.
I shall be able to give you a more comprehensive answer, once you get the report attached here in the follow up query.
For the time being, I can definitely understand your embarrassment and please don't worry of your health if you are aymptomatic.
Regards,
Dr. Kaushik
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hi Sir,
Thanks for your response. I think there is some problem in uploading of report so here I am writing line by line from report:
1. Fibro-infiltrative shadows suggestive of Koch's infections(? activity) is seen in left upper lobe.
2. Rest of the lungs field are clear.
3. Left hilum is pulled up.
4. The cardiothoracic ratio is maintained and the cardiac outline is normal.
5. The domes of the diaphragm are normal.
6. The cardio and costophrenic angles are clear.
7. Bony thorax is normal.
8. Suggest clinicopathological correlation
Of the above Point 1 and Point 3 are puts in bold font. I will try to upload reports after sometime because currently I am not able to upload any report.
I am feeling very tensed and stressed since last few days because of this and looking for your help on this.
Thanks & regards,
Thanks for your response. I think there is some problem in uploading of report so here I am writing line by line from report:
1. Fibro-infiltrative shadows suggestive of Koch's infections(? activity) is seen in left upper lobe.
2. Rest of the lungs field are clear.
3. Left hilum is pulled up.
4. The cardiothoracic ratio is maintained and the cardiac outline is normal.
5. The domes of the diaphragm are normal.
6. The cardio and costophrenic angles are clear.
7. Bony thorax is normal.
8. Suggest clinicopathological correlation
Of the above Point 1 and Point 3 are puts in bold font. I will try to upload reports after sometime because currently I am not able to upload any report.
I am feeling very tensed and stressed since last few days because of this and looking for your help on this.
Thanks & regards,
Brief Answer:
Details written below
Detailed Answer:
Thanks for your wise and prompt reply.
Explanation of 1) As I have explained earlier there are fibro-infiltrative swelling. But, any acute form of any fibro-infiltrative disease of lung can not be differentiated by Xray from any chronic change or resultant of healed up Koch's (tubercular) infection. So, they could not differentiate the activity status (whether your disease is active or healed up), obviously because chronic lesions heal with fibrosis, which is permanent and remains as it is after cure.
Explanation of 3) You probably have left upper lobe atelectasis. This means that the alveoli or the air balloons in this area of your lung cannot retain air, becuse they have collapsed and the walls are apposed. This is also sequelae of the fibrotic change in the lung.
If you have any history of recent sputum or weight loss or shortness of breath, you need to be evaluated.
Best advice would be, get clinically examined by your local chest physician. You may also need pulmonary rehabilitation exercise.
Hope you are satisfied with my answer. If that is so, please close the thread and rate my answer.
For any further query, please write back.
For any new query in future, you can directly ask me questions by making a direct query.
Regards,
Dr. Kaushik
Details written below
Detailed Answer:
Thanks for your wise and prompt reply.
Explanation of 1) As I have explained earlier there are fibro-infiltrative swelling. But, any acute form of any fibro-infiltrative disease of lung can not be differentiated by Xray from any chronic change or resultant of healed up Koch's (tubercular) infection. So, they could not differentiate the activity status (whether your disease is active or healed up), obviously because chronic lesions heal with fibrosis, which is permanent and remains as it is after cure.
Explanation of 3) You probably have left upper lobe atelectasis. This means that the alveoli or the air balloons in this area of your lung cannot retain air, becuse they have collapsed and the walls are apposed. This is also sequelae of the fibrotic change in the lung.
If you have any history of recent sputum or weight loss or shortness of breath, you need to be evaluated.
Best advice would be, get clinically examined by your local chest physician. You may also need pulmonary rehabilitation exercise.
Hope you are satisfied with my answer. If that is so, please close the thread and rate my answer.
For any further query, please write back.
For any new query in future, you can directly ask me questions by making a direct query.
Regards,
Dr. Kaushik
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hi Sir,
I do not have problem of sputum or weight loss. I do not know much about shortness of breath so I am not sure if I am having this problem. One thing is that if climb stair for 2-3 floors I get tired but i do not face any problem even i walk for long distance.
If possible please let me know what can be reasons for this left upper lobe atelectasis. Is my lifestyle can be reasons for this because due to long working hours i do not carry any exercise or regular walking.
Also last thing is this Atelectasis can be treated/cured (i.e. via medication and not through surgery) or not and whether this will appear always (lifetime) now onwards in my chest X-Ray because in my past X-ray there was no such problem. I am attaching here X-Ray report of 2009 and 2010 for your reference purpose which was done for medical insurance purpose.
Thanks and Regards,
I do not have problem of sputum or weight loss. I do not know much about shortness of breath so I am not sure if I am having this problem. One thing is that if climb stair for 2-3 floors I get tired but i do not face any problem even i walk for long distance.
If possible please let me know what can be reasons for this left upper lobe atelectasis. Is my lifestyle can be reasons for this because due to long working hours i do not carry any exercise or regular walking.
Also last thing is this Atelectasis can be treated/cured (i.e. via medication and not through surgery) or not and whether this will appear always (lifetime) now onwards in my chest X-Ray because in my past X-ray there was no such problem. I am attaching here X-Ray report of 2009 and 2010 for your reference purpose which was done for medical insurance purpose.
Thanks and Regards,
Brief Answer:
details written below
Detailed Answer:
Thanks for your reply.
The answers are-
1. I don't think your lifestyle is responsible for your present status. But, you should do exercise for at least 30 min/day to stay healthy.
2. I don't think that can be reversed. That was due to fibrosis during healing of pulm. TB. And fibrosis is permanent. Also you don't need any treatment for the same unless you are symptomatic. Only pulmonary rehab exercises can be done after consulting your pulmonologist.
3.This fibrotic change would appear also in future in your chest xray. If there is new onset interstitial fibrosis, it would increase.
Hope, you are satisfied with my answer. If that is so, please close the thread and rate my answer.
For any further questions, please write back.
Regards,
Dr. Kaushik
details written below
Detailed Answer:
Thanks for your reply.
The answers are-
1. I don't think your lifestyle is responsible for your present status. But, you should do exercise for at least 30 min/day to stay healthy.
2. I don't think that can be reversed. That was due to fibrosis during healing of pulm. TB. And fibrosis is permanent. Also you don't need any treatment for the same unless you are symptomatic. Only pulmonary rehab exercises can be done after consulting your pulmonologist.
3.This fibrotic change would appear also in future in your chest xray. If there is new onset interstitial fibrosis, it would increase.
Hope, you are satisfied with my answer. If that is so, please close the thread and rate my answer.
For any further questions, please write back.
Regards,
Dr. Kaushik
Above answer was peer-reviewed by :
Dr. Prasad
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