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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does Fibronodular Change In Upper Lung Zone On Chest X-ray Mean?

I had a shoulder xray which was normal, but it was noted that There is mild fibronadular change in the lateral left mid to upper lung zone. Correlation with current and/or prior chest radiographs is advised to begin further evaluation. I am 54 years old. When I was 22 years old I had pleurisy several times, which was quite painful and rather debilitating. When I saw a pulmonary specialist, he said he thought he would be seeing a much older patient, as there was scarring on my lungs similar to that of a TB patient. My maternal grandfather lived with TB for many years and live a block away, so I spent a lot of time with him. He eventually died from TB when I was 5 years old. Could I have possibly contracted some latent form of the disease which subsequentally went away on its own? I also had bacterial pneumonia for which I was hospitalized for about 3 weeks when I was around age 5 or 6 as well. My question is where should I go from here...
Tue, 23 Dec 2014
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Pulmonologist,  's  Response
Thanks for your question on HCM.
I can understand your situation and problem.
Any lung insult whether infection, injury or trauma can cause healing. And healing in lung is seen as
1. Fibrosis
2. Calcification
3. Rarely complete resolution.
So in my opinion you are having healed lesion of old pneumonia.
But at present we need to rule out its activity.
So consult pulmonologist and get done
1. CT THORAX
2. BRONCHOSCOPY AND BAL ( Broncho Alveolar Lavage ) analysis for TB.
As CT is much better than chest x ray for parenchymal lesion.
And BAL analysis is far better than sputum in determining TB.
If both are negative than no need for anti TB drugs. This is old, inactive scar tissue.
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What Does Fibronodular Change In Upper Lung Zone On Chest X-ray Mean?

Thanks for your question on HCM. I can understand your situation and problem. Any lung insult whether infection, injury or trauma can cause healing. And healing in lung is seen as 1. Fibrosis 2. Calcification 3. Rarely complete resolution. So in my opinion you are having healed lesion of old pneumonia. But at present we need to rule out its activity. So consult pulmonologist and get done 1. CT THORAX 2. BRONCHOSCOPY AND BAL ( Broncho Alveolar Lavage ) analysis for TB. As CT is much better than chest x ray for parenchymal lesion. And BAL analysis is far better than sputum in determining TB. If both are negative than no need for anti TB drugs. This is old, inactive scar tissue.