Left Apical Pleural Fibrosis: Should You Be Concerned? - Pulmonology

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Fibrosis of the left apical pleura?


I apologize for the interruption.
I am 22 years old and a junior in college.
A few days ago, I reviewed my school health check report, which indicated left apical pleural fibrosis.
I would like to ask if this condition is serious.
I do not smoke or drink alcohol, nor do I work in environments with exposure to chemicals or dust.
There is no family history of diseases.
However, I occasionally experience a lot of phlegm, a scratchy throat that leads to dry coughing, and due to a lack of exercise, I often feel short of breath after running a little.
Additionally, my anxious personality and mild autonomic nervous system dysregulation sometimes cause me to feel chest tightness and difficulty breathing, requiring deep breaths.
The health check report was from August 2020, and prior to that, I had X-rays and pulmonary function tests in July and November 2019, which showed no abnormalities.
However, the August 2020 results indicated left apical pleural fibrosis, which makes me very anxious.
I would like to know if this condition is serious or if it could be a misinterpretation of the test results.
Would you recommend getting another examination? Thank you.

hen jiao lv de xue sheng, 20~29 year old female. Ask Date: 2021/02/23

Dr. Wu Yingxun reply Pulmonology


Hello: Apical pleural fibrosis is quite common, indicating that there has been previous inflammation that left scar tissue.
It is harmless to the body, and annual X-ray examinations for monitoring are sufficient.

Reply Date: 2021/02/23

More Info


Left apical pleural fibrosis, as indicated in your recent health check report, refers to a thickening or scarring of the pleura (the membrane surrounding the lungs) in the upper part of the left lung. This condition can arise from various causes, including previous infections, inflammation, or exposure to certain irritants. Given your age and the absence of significant risk factors such as smoking, alcohol use, or occupational exposure to harmful substances, it is understandable to feel anxious about this finding.

First and foremost, it is essential to recognize that pleural fibrosis can be a benign condition, especially in younger individuals without a history of significant lung disease. The fact that you have no family history of lung disease and have not been exposed to known risk factors is reassuring. However, the presence of symptoms such as chronic cough, phlegm production, and occasional chest tightness should not be overlooked.

Your symptoms may be related to several factors, including anxiety, which can manifest as physical symptoms such as shortness of breath and chest discomfort. The feeling of needing to take deep breaths can often be linked to anxiety or stress, especially if you have a tendency toward nervousness. Additionally, a lack of physical activity can contribute to feelings of breathlessness during exertion, as your body may not be accustomed to increased physical demands.

Regarding the fibrosis itself, it is crucial to consider the context in which it was found. If this finding is new compared to previous imaging studies, it may warrant further investigation. While it is possible that the fibrosis is a benign finding, it is also essential to rule out any underlying conditions that may require attention. A follow-up with a healthcare provider, preferably a pulmonologist, would be advisable. They may recommend additional imaging studies, such as a CT scan, which can provide more detailed information about the lung structure and help assess the extent of the fibrosis.

In terms of management, if the fibrosis is determined to be stable and not causing significant symptoms, monitoring may be all that is necessary. However, if you continue to experience symptoms like chronic cough or shortness of breath, pulmonary function tests may be beneficial to assess how well your lungs are working.
In conclusion, while left apical pleural fibrosis can be concerning, especially when first identified, it is essential to approach the situation with a balanced perspective. Given your age and lack of significant risk factors, it is likely that this finding may not be severe. However, due to the presence of symptoms and the change in your imaging results, a follow-up evaluation with a healthcare provider is recommended to ensure that any potential issues are addressed and to provide you with peace of mind. Regular exercise, stress management techniques, and maintaining a healthy lifestyle can also contribute positively to your overall lung health and well-being.

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