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X-ray shows Fibronodular densities in right upper lobe. Meaning?

HI im 49 yrs.old i want to know the result of my xray yesterday.,can you please interpret this result. Fibronodular densities are seen the right upper lobe.hazy and streaky opacities in both lower lobes are also noted. Heart is not enlarged. Diaphragm and sulci are intact. The rest of the visualized osseous structure is otherwise unremarkable.

Asked On : Fri, 26 Apr 2013
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Radiologist 's  Response

Fibrotic lesions, especially of the upper lobes are usually sequelae to old infections like tuberculosis (Koch's), especially in third world countries. By themselves these do not indicate active disease. Streaky opacities in the the lower lungs may indicate active infection, especially if you have symptoms like cough or fever. This infection could be reactivation of old Koch's or some other bacterial infection.

If your primary symptom is breathlessness and you have occupational history to dust, coal, etc, these streaky opacities could represent interstitial lung disease. However, if you are a chronic smoker and.or have a blood in your sputum these streaky opacities may indicate more ominous problems. A CT scan of thorax maybe needed for further evaluation in either case. It is advisable that you meet a chest physician to discuss the problems.

Answered: Fri, 26 Apr 2013
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Pathologist and Microbiologist Dr. Shailja Puri 's  Response
Hello and welcome to HCM,

The X-ray chest reveals that there is a focus of tuberculosis in the upper lobe of right lung.
The lower lobes of both the lungs shows changes in the lung parenchyma.
Tuberculosis is an infection which needs to be treated at the earliest.
However, tuberculosis needs to be confirmed by culture (culture of AFB in sputum), PCR, or identification of AFB on ZN staining.
The other disease process interstitial lung disease is a chronic progressive disease. The severity of the disease is assessed by pulmonary function tests.
Steroids are used for the management of interstitial lung disease however, steroids are contraindicated in tuberculosis.

So, you need to consult a pulmonologist for relevant investigations and relevant treatment.

Thanks and take care.
Dr Shailja P Wahal

Answered: Fri, 26 Apr 2013
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Internal Medicine Specialist Dr. Prasad Akole's  Response
Dear friend, welcome and thanks for entrusting your query here at Healthcaremagic!
I am Dr. Prasad Akole (Critical Care Expert- and am glad to address to your query here.

Your Xray shows changes of fibrosis (fibre like changes of healed scars) and nodularity (small nodules) in the upper areas of the lungs, commonly due to old infections like tuberculosis (Koch’s) and others.
Lower lobes also show infiltrates suggestive of lung infection/ other infiltration like chronic granulomatous diseases.

It may be related to the upper lobe lesions or separate entities.
Diagnosis will depend on symptoms, history, clinical findings and other lab tests.

I hope to have answered your query satisfactorily. I would be glad to answer any further queries. Take care and please keep me informed of your progress at
Good Luck!

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Answered: Fri, 26 Apr 2013
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