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HRCT chest scan done. Is the presence of few small fibrotic bands indicate pulmonary fibrosis?

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Posted on Fri, 24 Aug 2012
Question: I just had my HRCT chest scan done. The report is "Mild changes of cylindrical bronchiectasis are seen in both lungs. Few small fibrotic bands are seen in posteriorbasal segment of left lower lobe....No other significant abnormality is noted XXXXXXX What are the possible medical problems I face now, and what are the treatment options? I do not have any symptoms, apart from very rare lightheadedness (which may or may not be related to the CT findings?) Is the presence of "few small fibrotic bands" indicate pulmonary fibrosis?
Thanks!
doctor
Answered by Dr. Gyanshankar Mishra (1 hour later)
Hi,
Thanks for posting the query on XXXXXXX
After going through your query, I would like to comment the following:

1. You are asymptomatic at present.

2. In view of the HRCT thorax findings, I would like to know the following:

a. Do you smoke?
b. In the past did you ever suffer from history of prolonged cough, TB, any other respiratory infection (Maybe in your childhood)?

Please do let me know the details so that I can answer accordingly.


Regards

Dr. Gyanshankar Mishra
MBBS MD DNB



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Gyanshankar Mishra (14 minutes later)
No, I have never smoked. I have never had any prolonged cough episode or TB. I am generally healthy and do not encounter any shortness of breath, etc even after 30 minutes walk on the treadmill at 4km per hour. I hope you could access the hrct report attached with my first question. I first had a routine health package which included a chest xray, and the hrct was done as a follow up of bronchovascular markings.
doctor
Answered by Dr. Gyanshankar Mishra (11 minutes later)
Hi,
Thanks for the follow up.
After going through your follow up query, I would like to comment the following:

1. The HRCT changes are most likely a seuelea of some past respiratory infection which healed by itself.

2. No signs of active disease is seen at present.

3. You need to do a repeat ct thorax after 2 years.

4. If at any time you are symptomatic then you need to get investigated.

5. In the mean while you can get your pulmonary function tests done, yearly xray chest should be done. Get your 6 minute walk test done for any fall in oxygen saturation. These can be done in consultation with a Pulmonologist.

6. If there is no inhalational dust exposure at in your life style and no any other medical problem then there is no need for you to worry.

7. You should consider yearly flu vaccinations and 5 yearly pneumococcal vaccinations to prevent any secondary respiratory infection in your case.

8. Overall since you are asymptomatic please do not worry.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Gyanshankar Mishra (25 minutes later)
Just to get things clear, the fibrotic bands are not indicative of pulmonary fibrosis? Is there any therapy needed now..any likelihood of my hrct findings exacerbating in the future or not reversible? What would the hrct show in case of pulmonary fibrosis? Thanks...
doctor
Answered by Dr. Gyanshankar Mishra (1 hour later)
Hi,
Thanks for the follow up.
The picture of idiopathic pulmonary fibrosis or diffuse parenchymal lung disease does not match with your presentation. Currently since you are asymptomatic no therapy is needed. But please get the investigations done as I have mentioned earlier, to catch any comorbid disease process if present at an earlier stage.
Rememeber that bronchiectasis or fibrosis are irreversible changes. They are like inactive scar marks on the lungs which do not pose any threat unless they get secondarily infected. Hence if you develop ant respiratory complaints in the future please do not delay to seek medical advise.

The HRCT thorax findings of idiopathic pulmonary fibrosis has to show subpleural lesions, ground glass opacities in early stage and honeycombing in later stage. Bilateral basal subpleural lesions with restrictive pattern on Pulmonary function tests, Decreased DLCO, Decreased excercise capacity, etc.

Please get yourself investigated and vaccinated as mentioned above.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.

Regards

Dr. Gyanshankar Mishra
MBBS MD DNB

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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HRCT chest scan done. Is the presence of few small fibrotic bands indicate pulmonary fibrosis?

Hi,
Thanks for posting the query on XXXXXXX
After going through your query, I would like to comment the following:

1. You are asymptomatic at present.

2. In view of the HRCT thorax findings, I would like to know the following:

a. Do you smoke?
b. In the past did you ever suffer from history of prolonged cough, TB, any other respiratory infection (Maybe in your childhood)?

Please do let me know the details so that I can answer accordingly.


Regards

Dr. Gyanshankar Mishra
MBBS MD DNB