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Chest x-ray showing fibrolinear density in upper lungs. Secondary PTB. Is the result correct?

Hi! I got my x-ray result yesterday for chest apico lordotic view. It says that: Reveals fibrolinear densities on both upper lungs. The rest of the chest structures are distorted due to positioning. The superior mediastinum is not remarkable. The osseous thoracic cage reveals no significant bony abnormality. Conclusion: Secondary PTB, both upper lungs - Reray in 12 weeks. My question is can this result be wrong? Is there any possibility that it isn t PTB?
Asked On : Wed, 27 Feb 2013
Answers:  1 Views:  268
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Pulmonologist 's  Response
It is important to know why you went to the doctor which led to you requiring a chest x-ray. The upper lobes changes that you described is quite possibly due to old TB you possibly had in the past. If you don't have history of any TB treatment, possibly you had exposure to TB bacteria where the bug goes to the lung and hibernate. This could lead to what is normally called Latent TB, where the TB bug is sleeping in your lungs due to your good immune system. However, whenever your immune system goes down it can get reactivated which is called secondary TB. If you get diabetes or certain treatments for like Rheumatoid Arthritis, or certain immune related disease, the treatment could reactivate the sleeping latent TB.
Having said this it is important to have a detail history including where you live and where you have lived in the past is important. If you are in the western hemisphere, it could be due to other conditions, or occupation, any exposure to silica, coal dust and also any important treatment. One cannot come to specific diagnosis by radiology alone. It should be a detail history, x- rays, and ideally a biopsy if required and your health status.
Answered: Fri, 1 Mar 2013
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