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Doctors Lounge - Chest Answers

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Forum Name: Miscellaneous Chest Diseases

Question: Lungs have mild Fibrotic Appearance. Pulmonary Fibrosis?


 rre24279 - Thu Apr 23, 2009 4:16 am Bookmark and Share  

I am healthy 26 yr old female. Smoker, Non-drinker. I have had two bouts of Acute Pancreatits. I was looking over my medical records and noticed that the results of a chest xray say this: "heart size is normal. Lungs have mild fibrotic appearance. No active lung infiltration, pulmonary vascular congestion, or pleural effusion is identified. IMPRESSION: No active disease is identified." Also, the results of my CT scan say "mild dependant Atelectasis is present at visualized lung bases." and another says "There is mild dependant Atelectasis in both lung bases."

My doctor has never mentioned this to me, and I don't know if this is something I should be concerned about. I am aware that atelectasis can be caused by abdominal pain due to shallow breathing, and at the time of the first CT scan, I was in the ER with a Lipase level of 27,486 UL and in extreme pain, but the 2nd scan was 2 days later while I was receiving IV Demerol and my pain/breathing was controlled. I sometimes have shortness of breath, coughing, and feel tiny stabbing pains in my chest over my heart. I have started using nicotine patches to quit smoking, but I am worried. Does the statement that my lungs have a mild fibrotic appearance mean that I have Pulmonary Fibrosis? Thank you in advance for your help.
 John Kenyon, CNA - Sat Apr 25, 2009 9:36 pm Bookmark and Share  

User avatar Hello --

While your radiology report states "mild fibrotic appearance" and while this may well be correct and even related in one of two ways to the pancreatitis, it doesn't rise to the level of concern, because it could also be due to smoking and mainly it just isn't that unusual, neither radiologically nor symptomatically. For that reason I would not be concerned, and as of now you do not have pulmonary fibrosis.

The two possible causes of this appearance, as well as the atelactasis, are 1) the thing you mentioned, the guarding over breathing during severe abdominal pain and 2) a sometimes genetic predisposition to fibrotic disease which may have affected the pancreas and could also cause "mild fibrotic appearance" in other organ systems as well, generally without symptoms or any actual disease.

In any case your report is not remarkable, and the only suggestion I would attach is that you have repeat CT of the chest periodically (every few years) for a couple cycles, just to be certain there's no progression to actual disease, although you would likely develop symptoms in the meantime anyway. The best thing you can do for yourself right now is to go forward with your smoking cessation program. Otherwise I would not be worries at all, and just keep treating yourself right. Be well. Good luck to you.
 rre24279 - Sun Apr 26, 2009 3:44 am Bookmark and Share  

Thank you very much. You have definitely made me feel a lot better about this. I will follow up with my Doctor and try to take care of myself. I still have no definitive answer as to why I developed Pancreatitis, but all other organ systems are in tip-top shape, so I am hopeful that I'm mostly healthy. Anyways, Thank you again. I appreciate the time that you took to answer my question. It is nice to find that there are people out there that actually do care enough to ease another's mind.

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