Lung Fibrosis and Nodules: Key Insights for Patients

Q: Lung Fibrosis and Nodules: Key Insights for Patients

Hello： The first area of fibrosis appears as a band-like structure, which typically does not change much, resembling a small scar in the lung tissue, so there is less cause for concern. <br>The second area is a small nodule measuring 3mm, which requires closer monitoring to see i

Please provide information on pulmonary fibrosis and pulmonary nodules?

Hello, Doctor: I would like to ask the following questions and would greatly appreciate your clarification.

Result: Y
Finding: Low dose chest CT without IV contrast administration:
- The low dose protocol is designed for lung nodule detection and has inherent poor low-contrast resolution, which is not appropriate for extrapulmonary evaluation.

- Fibrotic opacity over the right lower lobe (RLL) is noted; follow-up is suggested.

- A nodule is noted over the left major fissure (axial: 34, coronal: 21); follow-up is suggested.

- No obvious enlarged lymph nodes in the mediastinum.

- No enlargement of bilateral adrenal glands.

- A 5.5 cm low attenuation subcutaneous mass is noted over the right upper abdominal wall, rule out lipoma.

- Mild degenerative joint disease (DJD) changes of the thoracolumbar spine with spur formation.

Impression: A nodule is noted over the left major fissure; follow-up is suggested.
In October 2020, I underwent a low-dose CT scan of the lungs as part of a health check-up.
The report indicated fibrotic changes resembling a "Y" shape in the right lower lung and a 3 mm nodule in the left lung.
I returned to the hospital for a follow-up and had another low-dose CT scan three months later.
The English report above is from my scan in February this year.
I would like to ask you two questions:
1.
In the report, the fibrotic opacity over the RLL (first finding) and the nodule over the left major fissure (second finding) – are these two findings related, and which one should I be more concerned about?
2.
Additionally, since there was no change in the appearance of the first finding after three months, but the second finding appeared less distinct, the doctor mentioned that the second finding might be more indicative of inflammation.
However, I am more concerned about the first finding, as it has a "Y" shape and is about 1 cm in size.
Should I consider this a nodule? How often should I return to the hospital for follow-up low-dose scans? Thank you.

Jerry Lin, 40~49 year old female. Ask Date: 2021/09/07

Dr. Yang Wenda reply Pulmonology

Hello: The first area of fibrosis appears as a band-like structure, which typically does not change much, resembling a small scar in the lung tissue, so there is less cause for concern.
The second area is a small nodule measuring 3mm, which requires closer monitoring to see if it increases in size or density.
According to the report, it seems that the size has not changed, and it appears to have become less dense, indicating no deterioration.
It is recommended to follow up with a low-dose computed tomography scan in six months to a year.

Reply Date: 2021/09/07

More Info

Understanding lung fibrosis and nodules is crucial for patients, especially when faced with findings from imaging studies such as low-dose CT scans. The report you provided indicates the presence of fibrotic opacity in the right lower lobe (RLL) and a nodule in the left major fissure. Let's break down these findings and their implications.

1. Understanding the Findings
Fibrotic Opacity: This refers to areas in the lung where normal lung tissue has been replaced by fibrous tissue, which can occur due to various reasons, including chronic inflammation, previous infections, or exposure to harmful substances (like asbestos or silica). The presence of fibrotic changes can indicate a chronic process, and while it may not be immediately alarming, it requires monitoring to ensure it does not progress.

Nodule: A nodule is a small, rounded growth in the lung that can be benign or malignant. The report mentions a 3mm nodule in the left major fissure, which is relatively small. Nodules can be caused by infections, inflammatory processes, or tumors. The fact that the nodule has changed in appearance over three months is a positive sign, as it suggests that it may not be a malignant process.

2. Comparison of the Two Findings
The fibrotic opacity and the nodule are not the same; they represent different pathological processes. The fibrotic opacity is indicative of a chronic condition, while the nodule is a discrete lesion that may require further evaluation. In general, nodules are often of greater concern than fibrotic changes, especially if they show growth or significant changes in appearance over time.

3. Monitoring and Follow-Up
Given that the fibrotic opacity has not changed and the nodule appears to be less prominent, it is essential to continue monitoring both findings. The standard approach for lung nodules, especially those that are small and stable, is to follow up with repeat imaging at intervals determined by the size and characteristics of the nodule. For a 3mm nodule that has shown a decrease in prominence, a follow-up CT scan in 6 to 12 months may be appropriate, depending on your physician's recommendations.

4. When to Seek Further Evaluation
If you experience any new symptoms, such as persistent cough, unexplained weight loss, or difficulty breathing, it is crucial to contact your healthcare provider immediately. These symptoms could indicate a change in your lung condition that may require more urgent evaluation.

Conclusion
In summary, while the presence of fibrotic opacity and a nodule in the lungs can be concerning, the stability of the fibrotic changes and the decrease in prominence of the nodule are reassuring. Regular follow-up imaging and consultations with your healthcare provider will help ensure that any potential issues are identified and managed promptly. Always feel free to discuss your concerns with your doctor, as they can provide personalized advice based on your medical history and current findings.

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