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What Does The Following Chest X-ray Report Indicate?
Question: STUDY: XR Chest PA and Lateral
DATE: 09/30/2016 15:15
INDICATION: Cough. History of tobacco use.
COMPARISON: 1/18/2015 and CT of the chest dated 6/27/2016.
FINDINGS: Frontal and left lateral views of the chest were obtained.
The cardiac, mediastinal and hilar silhouettes are stable. The heart
size is within normal limits. There is tortuosity of the thoracic
aorta. Faint, nonspecific areas of fine, interstitial density are
suggested in the perihilar regions bilaterally. No consolidating
infiltrates or pleural effusions are identified. No pneumothorax is
evident. No acute osseous abnormality is noted.
IMPRESSION:
There is mild diffuse accentuation of the perihilar interstitial
pulmonary markings. This could represent an atypical pneumonitis or
fibrosis.
DATE: 09/30/2016 15:15
INDICATION: Cough. History of tobacco use.
COMPARISON: 1/18/2015 and CT of the chest dated 6/27/2016.
FINDINGS: Frontal and left lateral views of the chest were obtained.
The cardiac, mediastinal and hilar silhouettes are stable. The heart
size is within normal limits. There is tortuosity of the thoracic
aorta. Faint, nonspecific areas of fine, interstitial density are
suggested in the perihilar regions bilaterally. No consolidating
infiltrates or pleural effusions are identified. No pneumothorax is
evident. No acute osseous abnormality is noted.
IMPRESSION:
There is mild diffuse accentuation of the perihilar interstitial
pulmonary markings. This could represent an atypical pneumonitis or
fibrosis.
Brief Answer:
not serious
Detailed Answer:
Hi and welcome.
Ok, I 'll comments only pathological findings.
Aortic tortuosity means that aorta, which is largest blood vessel in heart,is but curved and this is commonly seen and will cause no symptoms or problems. It is important that there is no aneurysm. There are also no suspicious lesions in lungs so tumors are ruled out. There are only small markings in the middle of the lungs which are not specific and may indicate small lung inflammation or fibrosis. This is not worrying sign but if you have symptoms such as fever,cough and pain in chest,you should do thorax CT scan which will be more precise.
Wish you good health. Regards
not serious
Detailed Answer:
Hi and welcome.
Ok, I 'll comments only pathological findings.
Aortic tortuosity means that aorta, which is largest blood vessel in heart,is but curved and this is commonly seen and will cause no symptoms or problems. It is important that there is no aneurysm. There are also no suspicious lesions in lungs so tumors are ruled out. There are only small markings in the middle of the lungs which are not specific and may indicate small lung inflammation or fibrosis. This is not worrying sign but if you have symptoms such as fever,cough and pain in chest,you should do thorax CT scan which will be more precise.
Wish you good health. Regards
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Here is my previous x-ray could you explain in common words I can understand?
Also from the first x-ray, should I be on antibotics?
CT Chest and High Resolution W/o IV Cont
Patient: XXXXXXX XXXXXXX L DOB: Oct 18, 1955
Report
EXAMINATION: CT chest and high resolution without intravenous contrast DATE: 6/27/2016 COMPARISON: 3/23/2016 INDICATION: 60-year-old woman with interstitial lung disease. Pulmonology note for 20/6/2016 indicates patient initially presented with shortness of breath, found to have pulmonary fibrosis on chest CT, methotrexate was stopped, history of smoking. Evaluate after 2 month cessation of methotrexate. TECHNIQUE: High-resolution CT images obtained in inspiration and expiration. Then, CT images obtained of the chest without intravenous contrast. Coronal and sagittal reformats available. FINDINGS: Thyroid within normal limits. Small hiatal hernia. Small fluid within the esophagus. Decreased size of subcentimeter mediastinal lymph nodes. Calcified hilar and subcarinal lymph nodes, likely sequelae of prior granulomatous disease.
Heart size normal with coronary artery calcifications. No pericardial effusion. Aorta normal in course and caliber with calcified atherosclerosis. Pulmonary artery caliber normal. Mosaic attenuation on high-resolution imaging. Resolution of previously visualized septal thickening. On inspiratory imaging, there are biapical subpleural interstitial opacities. No suspicious pulmonary mass or nodule. Main airways patent. No pleural effusion. Bilateral subpectoral breast implants. Axillary lymph nodes measure up to 1 cm, likely reactive. Chest wall soft tissue unremarkable. No acute or suspicious bony findings. Examination is not optimized for findings below the diaphragm. Visualized portion of the unenhanced liver, spleen, adrenal glands and upper renal poles are within normal limits. Surgical staples along the lesser curvature of the gastric body. Visualized portion of the unenhanced pancreas grossly normal. Gallbladder not visualized. IMPRESSION: 1. Previously visualized septal thickening was likely an acute process such as edema or viral infection. 2. Mosaic attenuation most suggestive of bronchiolitis obliterans. 3. Irregular peripheral upper lung opacities likely represents atypical fibrosis. 4. Decreased size of subcentimeter mediastinal lymph nodes. 4. Stable small hiatal hernia.
I asked a follow up question 22 hours ago and have yet to receive a reply.
Also from the first x-ray, should I be on antibotics?
CT Chest and High Resolution W/o IV Cont
Patient: XXXXXXX XXXXXXX L DOB: Oct 18, 1955
Report
EXAMINATION: CT chest and high resolution without intravenous contrast DATE: 6/27/2016 COMPARISON: 3/23/2016 INDICATION: 60-year-old woman with interstitial lung disease. Pulmonology note for 20/6/2016 indicates patient initially presented with shortness of breath, found to have pulmonary fibrosis on chest CT, methotrexate was stopped, history of smoking. Evaluate after 2 month cessation of methotrexate. TECHNIQUE: High-resolution CT images obtained in inspiration and expiration. Then, CT images obtained of the chest without intravenous contrast. Coronal and sagittal reformats available. FINDINGS: Thyroid within normal limits. Small hiatal hernia. Small fluid within the esophagus. Decreased size of subcentimeter mediastinal lymph nodes. Calcified hilar and subcarinal lymph nodes, likely sequelae of prior granulomatous disease.
Heart size normal with coronary artery calcifications. No pericardial effusion. Aorta normal in course and caliber with calcified atherosclerosis. Pulmonary artery caliber normal. Mosaic attenuation on high-resolution imaging. Resolution of previously visualized septal thickening. On inspiratory imaging, there are biapical subpleural interstitial opacities. No suspicious pulmonary mass or nodule. Main airways patent. No pleural effusion. Bilateral subpectoral breast implants. Axillary lymph nodes measure up to 1 cm, likely reactive. Chest wall soft tissue unremarkable. No acute or suspicious bony findings. Examination is not optimized for findings below the diaphragm. Visualized portion of the unenhanced liver, spleen, adrenal glands and upper renal poles are within normal limits. Surgical staples along the lesser curvature of the gastric body. Visualized portion of the unenhanced pancreas grossly normal. Gallbladder not visualized. IMPRESSION: 1. Previously visualized septal thickening was likely an acute process such as edema or viral infection. 2. Mosaic attenuation most suggestive of bronchiolitis obliterans. 3. Irregular peripheral upper lung opacities likely represents atypical fibrosis. 4. Decreased size of subcentimeter mediastinal lymph nodes. 4. Stable small hiatal hernia.
I asked a follow up question 22 hours ago and have yet to receive a reply.
Brief Answer:
hi
Detailed Answer:
If there are symptoms such as cough, fever, or elevated white blood count in blood then antibiotics should be taken for atypical pneumonia. However, this findings is not likely to be pneiumonia.
On this second CT scan: there is small area of fibrosis which represents thickening of lung tissue and further leads to obliteration of small alveoli. However, this is found only in small peripheral areas of lungs and this cant cause any symptoms if you ask me. Much more lung involvement is required to cause some subjective symptoms such as breathing difficulties or cough.
Bronchiolitis is also found in small area and this is inflammation of small bronchi. This is probably caused by viral infection. Hiatal hernia is small protrusion of stomach into thorax and this should not concern you.
All in all, it is hard to compare these 2 findings since one is CT and the other is chest xrays. But it looks like there is no progression of the disease and atypical pneumonitis or fibrosis on small lung area is not somehting serious and I dont think that antibiotics or steroids are required. It would be good to do lung ventilation tests and bronchoscopy if there are difficulties with breathing. Regards
hi
Detailed Answer:
If there are symptoms such as cough, fever, or elevated white blood count in blood then antibiotics should be taken for atypical pneumonia. However, this findings is not likely to be pneiumonia.
On this second CT scan: there is small area of fibrosis which represents thickening of lung tissue and further leads to obliteration of small alveoli. However, this is found only in small peripheral areas of lungs and this cant cause any symptoms if you ask me. Much more lung involvement is required to cause some subjective symptoms such as breathing difficulties or cough.
Bronchiolitis is also found in small area and this is inflammation of small bronchi. This is probably caused by viral infection. Hiatal hernia is small protrusion of stomach into thorax and this should not concern you.
All in all, it is hard to compare these 2 findings since one is CT and the other is chest xrays. But it looks like there is no progression of the disease and atypical pneumonitis or fibrosis on small lung area is not somehting serious and I dont think that antibiotics or steroids are required. It would be good to do lung ventilation tests and bronchoscopy if there are difficulties with breathing. Regards
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Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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