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Dr. Andrew Rynne

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What does this CT scan of chest regarding asthma indicate?

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Dr. Indu Kumar

Radiologist

Practicing since :2004

Answered : 6606 Questions

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Posted on Tue, 12 Aug 2014 in Lung and Chest disorders
Question: Hi I have a family member 51 non smoker. diagnosed with "adult onset asthma" 4 months ago. had a chest CT that shows this :

1. No discrete lung parenchymal mass. Multiple remote healed posterior
right rib fractures are noted, which may explain finding on chest x-ray.
2. Mild mediastinal and left hilar lymphadenopathy. .

she also on her cbc shows this high esonophils, and OCCASIONAL ATYPICAL LYMPHOCYTES PRESENT.
NORMOCYTIC, NORMOCHROMIC RED BLOOD CELLS

her LDH was 280 with the high normal being no higher than 237.

her symptoms include- diagnosed with "adult onset asthma" when this all started as well as chronic full body hives that are now controlled with allergy medications


please doctor what could this point to? she has NO other swollen nodes that CT said just in that area, her spleen is normal size, no lymphnodes found in the abdomen or axilla as they could see on CT scan...

could she have lymphoma? or leukemia?

her ONLY symptoms is a cough.... and chronic hives
I apologize her LDH was 237 with the normal high being no higher than 220 sorry about that
doctor
Answered by Dr. Indu Kumar 8 hours later
Brief Answer:
She has findings due to asthma.

Detailed Answer:
Hello XXXXXX
Thanks for writing to HCM

No,she is not suffering from lymphoma or leukemia.

Lymphoma or leukemia is associated with many other findings like altered hemogram,enlarged spleen,liver etc.She is not having these signs and lymphoma or leukemia is unlikely.

Her findings are typical of asthma.Increased eosinophil count also indicate towards this.

CT findings of thorax are absolutely benign.She has multiple healed rib fracture,it indicates past fracture and now it is healed.
Mild mediastinal and left hilar lymphadenopathy is a benign finding and it may be due to many factors like infection etc.It doesn't require any treatment.

Rest of the findings are within normal limit.LDH is also acceptable.
So,there is nothing to worry.She should take her medicines regularly.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indu Kumar 57 minutes later
could asthma and allergies , cause the lymphnodes to swell? or no? she had bronchitis back in the winter too - that's what started this mess. . . . and now for some reason , every time she goes outside she coughs and gets a hoarse voice and feels like stuff is draining but once she goes INSIDE it all gets better. . .

the radiologist on the CT scan stated "differential diagnosis is sarcoidosis, or lymphoma" that's what is scared me, so again I just ask you - I shouldn't lose sleep over this ?

sorry for the bothering question .
doctor
Answered by Dr. Indu Kumar 9 hours later
Brief Answer:
Please find detail answer below

Detailed Answer:
Hello XXXXXXX
Thanks for writing back

I think differential diagnosis of sarcoidosis or lymphoma in a case of mild mediastinal and left hilar lymphadenopathy is over diagnosis.

Sarcoidosis causes bilateral hilar lymphadenopathy and it is generally associated with calcifications.Patient may also have lung parenchyma involvement.These findings are absent in your case.

Lymphoma is also associated with many other features and only mild enlargement of mediastinal lymph nodes does't support this.Patient has many features like fever,sweating,itching,weight loss,tiredness etc.

I think first we should consider more benign reason like infection,inflammation etc.
Asthma generally doesn't cause hilar lymphadenopathy but bronchitis may cause lymphadenopathy.

You shouldn't worry.You should consult pulmonologist.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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