Your Chest Scan: Key Insights for Chronic Cough and Throat Phlegm

Q: Your Chest Scan: Key Insights for Chronic Cough and Throat Phlegm

Hello： It is recommended to consult the original prescribing physician regarding the relevant test reports, as they can provide explanations in conjunction with your original symptoms, other medical history, or family history.

Hello, doctor. I would like to ask for your help in reviewing my test results, as I have some questions I would like to discuss?

I have been experiencing a long-term cough and often feel phlegm in my throat.
I have seen many doctors at various clinics and taken numerous medications without improvement for several years (over 10 years, with a history of allergic conditions).
Eventually, I went to a large hospital for examinations, and I have some questions regarding the following reports:
1.
In the CT scan report, it states, "Some remnant of thymus is noted." Could you please explain what issues this might cause?
2.
The report mentions "No active lung lesion." Does this indicate that my lungs are normal and there are no problems?
3.
Regarding the X-ray report, what implications do the following findings have? Is there a need for follow-up examinations? I do not recall any injuries to my lungs, so why are these findings present?
- Mild increased interstitial markings of both lungs
- Thickening of bilateral apical pleura
- Mild increased interstitial markings of both lungs
4.
Additionally, could you explain what the sputum test report generally indicates? My main symptoms include a persistent cough that lasts almost all day, a feeling of phlegm in my airways, wheezing during severe episodes, and discomfort while lying down at night, making it hard to sleep.
Sometimes, I cough to the point of chest pain, and I often feel that my breathing is not smooth, almost as if my airways are constricted.
About two years ago, I underwent surgery for a deviated septum, which resolved my nasal congestion, but my cough persists.
I would appreciate your explanation as I am very concerned about my health.
Yadong Hospital CT Report:
- Some remnant of thymus.
- No active lung lesion.
- CT scan of the chest from the apex of the lung to the adrenal glands with contrast enhancement was performed, and the images revealed:
- No active lung lesion in both lungs.
- No significant mediastinal lymphadenopathy noted.
- Some remnant of thymus noted.
- Grossly normal appearance of bilateral adrenal glands.
- No osteolytic or osteoblastic bone lesion identified in visible bony structures.
Yadong Hospital Chest X-ray Report:
- Normal heart size.
- Clear bilateral costophrenic angles.
- Suggest clinical correlation and follow-up.
- Standing chest PA view:
- Heart size is within normal limits.
- Apical pleural thickening on the right side.
Lianxin Hospital Chest X-ray Report:
- Mild increased interstitial markings of both lungs.
- Clear bilateral costophrenic angles.
- Heart is normal in size.
- Thickening of bilateral apical pleura.
- Unremarkable upper abdomen.
Yadong Hospital Sputum Report:
- The specimen submitted consists of more than 10 tissue fragments measuring up to 2.8 x 1.2 x 0.3 cm in size, fixed in formalin.
Grossly, they are tan to brown and soft to bony.
A representative section is taken.
Microscopically, it shows some fragments of cartilage tissue with focal degenerative change and mild chronic inflammatory cell infiltration in the edematous stroma.
The overlying respiratory epithelium shows mild regenerative change.
The vascular component shows congestion.
The overall picture is consistent with degeneration with a chronic inflammatory process.
Please correlate with clinical condition and follow up.

Feng, 30~39 year old female. Ask Date: 2023/04/30

Dr. Yang Wenda reply Pulmonology

Hello: It is recommended to consult the original prescribing physician regarding the relevant test reports, as they can provide explanations in conjunction with your original symptoms, other medical history, or family history.

Reply Date: 2023/04/30

More Info

Understanding your chest scan results can be quite overwhelming, especially when dealing with chronic cough and throat phlegm. Let's break down your concerns based on the reports and symptoms you've shared.

1. Thymus Remnants
The report mentions "some remnant of thymus." The thymus is a small organ located in the upper chest, behind the sternum, and is crucial for the development of the immune system, particularly during childhood. In adults, the thymus often shrinks and may leave behind remnants. Generally, the presence of thymic remnants is not a cause for concern unless there are associated symptoms or abnormalities. It is common and usually does not affect lung function or contribute to respiratory symptoms.

2. No Active Lung Lesion
The phrase "no active lung lesion" indicates that there are no signs of current infections, tumors, or other significant abnormalities in your lungs. This is a positive finding, suggesting that your lungs are not currently affected by acute conditions such as pneumonia or malignancy. However, it does not rule out chronic conditions or previous damage that may not be actively inflamed.

3. Mild Increased Interstitial Markings and Pleural Thickening
The report notes "mild increased interstitial markings of both lungs" and "thickening of bilateral apical pleura." These findings can indicate a variety of conditions, including chronic bronchitis, interstitial lung disease, or previous infections. The interstitial markings suggest that there may be some degree of inflammation or fibrosis in the lung tissue, which could be related to your long-term cough and phlegm production. The thickening of the pleura may also be a response to chronic irritation or inflammation, possibly linked to your history of allergies and nasal issues.

4. Follow-Up Recommendations
Given your symptoms of chronic cough, throat phlegm, and the findings in your imaging studies, it is advisable to follow up with a healthcare provider. They may recommend pulmonary function tests to assess your lung capacity and function, as well as possibly a bronchoscopy if there is a need to visualize the airways directly.

5. Phlegm and Cough Symptoms
Your symptoms of persistent cough, phlegm production, and difficulty breathing could indeed be related to post-nasal drip from your history of allergies. Chronic nasal congestion can lead to mucus accumulation in the throat, triggering cough reflexes. It’s essential to manage your allergies effectively, as they can exacerbate respiratory symptoms.

Conclusion
In summary, while your imaging results show no active lung lesions, the presence of mild interstitial markings and pleural thickening warrants further evaluation, especially considering your chronic symptoms. It is crucial to maintain open communication with your healthcare provider, who can guide you through the necessary follow-up tests and potential treatments. Managing your allergies and any underlying conditions will be key to alleviating your symptoms and improving your quality of life.
If you have further questions or concerns, do not hesitate to reach out to your healthcare provider for personalized advice and management strategies.

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