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CT of chest showed some changes of centrilobular emphysema. Spirometry test normal with FVC-130%, FEV1-120% and FEV1%-74. Meaning?

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Internal Medicine Specialist
Practicing since : 2004
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I recently had a surgery and one of the pre-op test was a CT of chest. In the findings section-"there are some changes of centrilobular emphysema."In the Impression section -is says Emphysema.I passesd my pre-ops and recently had my annual physical and neither Doctor noted any irregularities.My spirometry test was normal with FVC 130% -FEV1-120%-and FEV1% 74. I have never smoked but work in second hand smoke environment-I dont have any symptoms and am quite physically active.What does this terminology mean.
Posted Sun, 11 Aug 2013 in X-ray, Lab tests and Scans
Answered by Dr. Enrique Molina 1 hour later
Even if you have never smoked, you may developed emphysema through second hand smoking environment, just as you mentioned you have been exposed at work.
"centrilobular emphysema", as reported on the CT scan is classic to be secondary to smoke (as opposed to other causes, such as genetic defects), and usually involves the upper half of the lungs.
Those numbers in the spirometry tests may seem normal, however to diagnose any COPD ("chronic obstructive pulmonary disease) such as Emphysema, we usually take into account the FVC (forced vital capacity) to FEV1 (forced expiratory volume in the 1st second) ratio, and the higher the difference, the more likely you are to have the disease.
Also the DLCO is usually decreased (also measured during the spirometry).
Finally, during the spirometry test, an inhaler such as albuterol (which open up the lungs, therefore called a "bronchodilator") is given to the patient, and the FEV1 will improve at least 12-15% if you have COPD or emphysema.
Mild COPD (emphysema) is defined as having an FEV1/FVC 80% predicted, and sometimes, but not always, chronic cough and sputum production. At this stage, the individual may not be aware that his or her lung function is abnormal. As numbers (percentages %) go lower, the worse is your emphysema. Therefore you may have mild to moderate emphysema.
I highly recommend you visiting a pulmonologist for further recommendations and treatment if necessary.
Hope that helped!! Let me know if you didn't understand something or if it was too technical.
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