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Bronchovascular lung markings / interstitial changes

British_Pluck profile image
12 Replies

I am anxious because of the slowness of the NHS. I had an x-ray in January and only now (six months later) in June have I been invited for a CT Scan. I am 65 and have never smoked or worked with dangerous substances. I had the x-ray because I take a leukaemia drug that can cause pleural effusion. What could my x-ray report possibly mean? I have no symptoms.

"Slightly coarsened bronchovascular lung markings / interstitial changes noted bilaterally mainly at the lung bases. No significant focus of collapse or consolidation. There is no appreciable pleural effusion. There is no pneumothorax."

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British_Pluck profile image
British_Pluck
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12 Replies
Alberta56 profile image
Alberta56

We are not medically qualified on this forum, and I can make no more sense of these findings than you can. I can only suggest you make a doctor's appointment, explain your concerns to him/her and ask him to interpret them. An entirely reasonable request by the way. Don't worry that you will be wasting your doctor's time.

British_Pluck profile image
British_Pluck in reply to Alberta56

Thank you. Neither my GP nor my haematologist was forthcoming with an explanation. I think that I will have to be patient now for a little longer. Unfortunately, my normally good Googling has not uncovered anything that helps me in this instance.

2greys profile image
2greys

Only from what I know, I am not a doctor or expert, just well read. I do not think the doctors are too worried or you would have had a CT scan long before this, even with the pandemic..

Bronchovascular markings are the visible markings made by the blood vessels supplying nutrients to the bronchi and bronchioles, this is not unusual. Such markings may only mean normal wear and tear, and may appear in people who would never have lung disease. A finding of prominent markings may reflect increased pressures within the lungs, but yours are described as being only slight, so I would not worry at this point in time.

Interstitial changes noted bilaterally mainly at the lung bases. This may indicate some slight scarring, possibly as the result of past infections or even pneumonia, which can sit at the base of the lungs, again this may not be anything to worry about, a lot of people will have some scarring from having infections.

You will have to wait for the follow up appointment to your scan to be sure, in the mean time relax, I am pretty sure you have nothing to worry about.

British_Pluck profile image
British_Pluck in reply to 2greys

Thank you, 2greys, for so kindly responding to me. I had my CT scan this morning, six months to the day since my x-ray.

Your posting has gone a long way towards putting my mind at rest. I take a "miracle" pill daily to keep my blood in a non-leukaemic status but it is known to cause pleural effusion and that was the concern of my haematologist. Anyway, I have been told that a report will be produced in two weeks' time. Presumably, even in the current circumstances, the NHS would have acted more quickly if the findings were likely to be dire. I will report back in due course. Again, many thanks.

Mavary profile image
Mavary

Hi Pluck. I’ve got a 5 mm Pulmonary node in my left lung and Bilateral subpleural interstitial as well. I’ve just really found out in the last few days. As long as the interstitial doesn’t progress I think it is ok. I’ve had pneumonia three times in my lifetime and I had TB when I was about four or five. So I can only presume that is what caused mine. Your Dr or Consultant is the one to ask why. I hope that helps.

British_Pluck profile image
British_Pluck in reply to Mavary

Yes, Mavary, that does help. Thank you. I cannot think back to any event that could have damaged my lungs. My suspicion now is that any damage has been caused by medication. I appreciate your sharing your own experience.

in reply to British_Pluck

Bog standard chest infections and even viruses can leave scarring behind under the ‘right’ circumstances, it doesn’t have to be pneumonia or a major illness like TB. Medication mediated lung injury is always a possibility, but as per 2greys reply, your x-ray results didn’t read as anything majorly worrying to me, either. However, I’m also nothing more than an enthusiastic amateur with a vested interest in better understanding respiratory medicine. Speaking from experience of drugs like methotrexate (arthritis doses, rather than chemo), if it is medication driven, you would generally expect it to worsen with continued use. If the causative drug is/has been stopped, then my understanding is the damage often halts: hopefully the ct will come back much the same as the x-ray, which would potentially suggest it’s a historical issue such as scarring, rather than an ongoing problem or anything current med related.

British_Pluck profile image
British_Pluck in reply to

Thank you, Charlie. This is another encouraging answer. I complained to the haematologist about pain in my back and chest which triggered the referral for the x-ray. However, the pain was the result of a pre-existing hiatus hernia which was resolved by an increase in my lansoprozole medication. The haematologist was primarily concerned about the possibility of pleural effusion. The x-ray findings, therefore, have been observed by accident. I should have a report from my CT scan in a few weeks' time.

Alberta56 profile image
Alberta56

I'm glad 2greys has been able to help. Be careful with Google. It has seriously worried some people who visit this site by giving them outdated and much too dire prognoses.

deni-123red_ profile image
deni-123red_

2greys has recently helped me and I value his opinion. I do hope your mind will be put at rest when you get your report. I know how worrying these things can be. Wishing you all the best

British_Pluck profile image
British_Pluck

This has been a slow business with the NHS in its current state. After 7 months, I had my CT scan and have acquired the report. The report is quite long but the concluding factors are as follows:

Unusual appearance with many fine parenchymal bands see being seen within the lungs are mostly projecting in the lung from mildly thickened or nodular pleura. Appearances are unusual and could be related to some past insult such as infection. The pattern is not typical of a specific interstitial lung disease but discussion at the interstitial lung disease meeting may be helpful.

I now await a consultation invite.

vwtopaz profile image
vwtopaz

Hi, hope you get your appointment soon to discuss these findings.

Very best wishes, take care.

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