Brief Answer:
Pls be concerned if breathlessness, cough is there

Detailed Answer:
Hi XXXXXXX
Thanks for writing in to us.

I have read though your query in detail.
Regularly I see patients with CT findings as in you. The CT scan findings are explained blow in simple language.

1. Trachea and oesophagus normal,
This describes the large airway to be normal.

2. XXXXXXX main bronchi and hila on both sides appear normal.
This means that the bifurcation of trachea (carina) and the main bronchus entering each lung (hilum) is normal.

3. Parenchyma of both lungs show accentuated bronchovascular markings ? age related ? COPD;
The lungs show more prominent air spaces seen as accentuated lung markings. This can be seen in elderly and also in people whit some kind of chronic obstructive pulmonary disease where the air gets trapped.

4. no pleural pathology is noted.
The thin covering of lungs is normal.

5. There is no evidence of any mass lesion in the lungs, cardiac size is within normal limits, bones and soft tissue appear normal
There is no feature to suggest any tumor like problem. The heart, rib cage and chest wall muscles are normal.

6. Impression: Parenchyma of both lungs show accentuated bronchovascular markings - ? age related ? COPD no other obvious abnormality detected
This is the conclusion and suggests that the lung markings are conspicuous and might be age related or due to Chronic obstructive lung disease (COPD) which describes a group of lung conditions (diseases) that make it difficult to empty the air out of the lungs.

As no bulla is mentioned, the suspected bullae on chest X ray may correspond to the air trapping seen as accentuated bronchovascular markings.

COPD is more commonly seen in those who smoke and are exposed to pollutants. Spirometry is the only accurate method of measuring the airflow obstruction in patients with COPD. This has to be discussed with a pulmonologist if you have any abnormal breathing lung volumes on spirometry.

Clinically, the diagnosis of COPD is suspected on the basis of symptoms (particularly breathlessness or cough) and signs, and supported by spirometry.

I am interested in viewing your CT scan images and report if possible. This is to doubly make certain that there are no bullae which have been missed as you say the abdomen CT did show some bullae at bases.

Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
Pls attach pictures or upload online using dropbox

Detailed Answer:
Hi XXXXXXX
Thanks for writing back with an update.

After reading the report, I understand that the doctor is referring to small bullae in the lower lobes of lungs. This is not something to get worried about. Since this is entirely web based, sending by courier is not safe.

1. I would like you to please take picture of CT films on camera and attach them to your query and again write back to me. I will have a look at that.

or

2. Alternatively, you can get the CT scan chest on a DVD from XXXXXXX Diagnostics and then upload contents online to a free internet uploading service like dropbox and write back sending me download link. That way I will download the entire CT scan and see it just as your doctor has seen them and give my opinion

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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