Emphysema Confusion

Hi All,

I am 40 years old and healthy and fit.

Recently i went for a lung cancer screening referred by my GP in UK. In th CT scan, there were no lesions, no abnormalities and healthy lung. But radiologist mentioned that there is a solitary tiniest (around 1-2mm) emphysema. I don't have any symptoms and perfectly fine with my health. running around 30mins every day in park or on treadmill without any respiratory issues. I never smoked more than 3 cigarettes( not packs) a day in my life. I was a very light smoker. I used to smoke 1 -3 cigarettes a day (mon-fri), 3 months on and 1 month off. I stopped completely last year. I never visited GP with any serious respiratory issues other than seasonal flu symptoms (once in a year at the most) .

Chest clinic registrar wrote "very mild emphysema" in his report but did not mention anything about follow up and no additional notes on this. I spoke to him on the phone later on to confirm what it means. He told me that radiologist found tiniest emphysema of 1-2mm size and it is solitary(only one) and the lung is healthy. He told me that it will not progress unless i start smoking again. I asked him if it is COPD. He told me that COPD is clinical examination and he dont think i have got COPD as my lung function tests are pretty good (FEV1 vs FCV ratio is 99% as per my private spirometry tests). I am totally down with the word "Emphysema". This word affects me a lot in life as this is creating me medical anxiety and negative thoughts.

I am totally confused what to do. Do i really have emphysema(COPD)? Will it be recorded as emphysema patient in my medical records. Can this incidental high resolution CT scan finding of tiniest emphysema be considered as i got emphysema lung disease, can the CT finding be wrong ?

I called my father in law (who is a retired professor ENT and General Medicine) and his Friend ( Professor , Respiratory Medicine & Surgery) in India and asked them about my report and ct findings . They told me that they don't think that i've got emphysema as i am not a heavy smoker and i am not living or working in polluted environment and i don't have alpha-1 deficiency. They are thinking that this incidental finding may be misinterpreted as emphysema as there are several factors make something appear as emphysema in lungs while taking CT Scans in their experience. They said that there is a possibility of ct artifact . They also told me that they don't diagnose emphysema just based on a single incidental tiny finding in High resolution CT Scan and use several other factors like patient history, symptoms and lung function tests along with CT findings. They said that this is just a radio graphic incidental finding and not the final diagnosis and radio graphic findings probably go wrong particularly with a very small solitary tiniest findings. In their experience , 100% of the times, these incidental findings did not turn as emphysema in the follow ups.

Since i read my chest registrar's report , i became anxious and unable to concentrate on anything other than searching google for reversing emphysema although my father in law and his friend reassured me that i don't have emphysema based on my lung function tests , ct scan radiologist report , my history and my current and past health.

I am sleepless thinking of emphysema all the day. Getting restless and mourning myself.

There are a lot of unanswered questions to me :

1. In UK, if CT scan incidental finding of the tiniest emphysematous change be categorised as generalised emphysama and COPD?

2. Will this be recorded in my medical file as "Emphysema" just based on single incidental radiological finding?

3. Do i really have emphysema and COPD?

4. Can i live my entire life without any problems (like loss of breath , inhillars ,oxygen)?

5. Is this 1-2mm solitary emphysema progress to life threatening?

6. In UK, Do High Resolution CT scan radiologist report on incidental tiniest findings like this be go wrong?

7. Is this end of my financial life as i will not be able to get any mortgage insurance or life insurance or health insurance with emphysema (although it is only 1-2 mm tiniest solitary very mild emphysema ) ?

Please help me. If someone faced the same issue like me : An incidental finding of a single solitary tiniest emphysema in their chest ct scan without any symptoms and light smoking history, Did it treated as emphysema by doctors and recorded in their medical file here in UK?

In India, someone told me that it turned as pseudo emphysema in the followup CT scan. I don't want to go for another CT scan as it is more radiation.