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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Chest X-ray Shows Bilateral Mild Bronchiecatasis, Mild Fibrosis. What Can You Say?

Dear Dr. Samuel, 1st =my CXR report Impression (features suggestive of early PTB) 2nd= CTScan Finding (small area of peripheral intralobular reticular opacities at the apical segment of right upper lobe. very fine centrilobular nodules in the anterior periphery of : 1)the apical segments of upper lobes bilaterally and 2) anterior segment of right upper lobe. Linear opacities extending from peribronchiovascular interstitium to pleural surface at the posterior basal segments of both lower lobes. They are associated with mild pleural thickening and tenting Mild bronchiectasis in all the segments of right upper lobe, anterior and lingular segments of left upper lobe,medial segment of middle lobe, and basal segment of left lower lobe. No pleural effusion . Multiple subcentimetre paratracheal nodes, biggest 9mm t pretracheal region at the level of aortic aech. No enlarged hilar or axillary node. Impression: 1) cannot exclude mild early PTB in upper lobes. 2)extensive bilateral mild bronchiecatasis 3)Bilateral lower mild fibrobis due to old infection. what can you say by looking at my report. thank you CSY
Mon, 27 Aug 2012
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General & Family Physician 's  Response
Obviously, there is a lot going on. I would start with a TB blood test, a full auto immune panel and a High Resolution CT of the Chest using 1 to 2 mm slices to see if there is any evidence of active pulmonary inflammation. You may ultimately require a fiberoptic bronchoscopy and or a lung biopsy.
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Chest X-ray Shows Bilateral Mild Bronchiecatasis, Mild Fibrosis. What Can You Say?

Obviously, there is a lot going on. I would start with a TB blood test, a full auto immune panel and a High Resolution CT of the Chest using 1 to 2 mm slices to see if there is any evidence of active pulmonary inflammation. You may ultimately require a fiberoptic bronchoscopy and or a lung biopsy.