What Does "right Upper Lobe Fibrotic Strands" In A X Ray Report Indicate?

Posted on Tue, 7 Apr 2015

Question: Dear Dr.,
Recently i underwent Xray test for Australian immigration. The report says "right upper lobe fibrotic strands"...what does this mean? what further tests might be required to give clean certificate?

Answered by Dr. S. Samanta (13 minutes later)

Brief Answer:
You may need lung function, sputum and Mantoux tests !

Detailed Answer:
Hi, Mr. XXXXXXX thanks for your health query!

Well, "right upper lobe fibrotic strands" in your chest x-ray report indicates some scars/evidence of old healed infection/inflammation could be silent/old pneumonia, allergic reaction, injury or even tuberculosis but not malignancy!

Therefore, you need to go for lung function test, sputum test and Mantoux test and if possible a CT scan of thorax for confirmation/detailing.

Regards,

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. S. Samanta (1 hour later)

Dear Dr
Thank you for the reply. Are these tests mentioned by you done on the person for confirming whether active TB is present or Old TB got healed?

Is there any method available exactly to find out whether Old TB was treated and healed?

Also why did the previous X Rays done in New Zealand in Aug 2012 , and in XXXXXXX in sep 2014 did not reveal this fibrotic strands?

Answered by Dr. S. Samanta (11 minutes later)

Brief Answer:
Biopsy can only confirm this!

Detailed Answer:
Hi! thanks for your feedback!

There are some serological tests like TB GOLD/TB INTERFERON TESTS and needle biopsy from the lesion under CT SCAN guidance with TB PCR that can confirm the active disease!

However, the x-ray picture you mentioned is not that of active tuberculosis.

Possibilities behind the fact that the previous X Rays done in New Zealand in Aug 2012 , and in XXXXXXX in sep 2014 did not reveal this fibrotic strands could be:

1. the fibrotic strands take 3-6 weeks minimum to develop

2. minor findings could be overlooked

3. positioning of the patient was not appropriate

4. technical limitations of the machines or the personnels involved

Regards!

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. S. Samanta (26 minutes later)

Thank you very much Doctor for the replies...One last question., Will this biopsy, serological tests TB GOLD/TB INTERFERON TESTS, TB PCR be part of the immigration tests as iam worried these will delay the PR process...

Answered by Dr. S. Samanta (9 minutes later)

Brief Answer:
POSSIBLY NOT!

Detailed Answer:
Hi! this is a minor finding in x-ray and generally ignored as such if the person is asymptomatic!

Moreover, this could also be over-reporting; I mean, over-interpreted but the person is actually not having this; some artifacts...etc..only CT scan can confirm the spots...

Wishing you great success ahead!

Above answer was peer-reviewed by : Dr. Vaishalee Punj