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What Does This CT Scan Report Indicate?

Posted on Sat, 11 Jun 2016

Question: Hello Doctor,

I have just gone through a CT scan and the results are as below:

1. MILD SUBPLEURAL FIBROTIC OPACITIES IN BILATERAL APICAL REGIONS.
2. NO ACTIVE LUNG PARENCHYMAL INFECTION SEEN

P.S. I never suffered with TB in my whole life. I was gone through a chest x-ray last month which showed below results:
1. Evidence of Tuberculosis- Present- Minimal density seen i Lt. apex.
2. Lung fields- Abnormal- Minimal density seen in Lt. apex.

Please advise what does it mean.

Thanks,

XXXX

Answered by Dr. Drkaushal85 (2 hours later)

Brief Answer:
No need to worry for this CT report.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
Your CT report is suggestive of old, healed, scarred lesion.
Almost all lung insults whether tuberculosis, pneumonia or lung injury heal by either fibrosis or pleural thickening or calcification.
This is natural healing process.
And they will last life long.
So no need to worry for such healed lesions.
Sometimes, there is no prior history of any lung insult and yet these healed lesions are seen.
So if you are asymptomatic then nothing should be done.
Please let me know
1. Do you have cough, fever, weight loss?
2. Do you smoke?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (2 hours later)

Hi Dr XXXXXXX

Thank you for your reply.

Below are the answers of above questions:

1. No, I do not ave cough, fever, weight loss. My weight has increased by 3 Kg in last 2 months time and my HB has gone up to 11.9 from 10.3 in last 2 months.
2. No. I do not smoke and i never did.

Thanks,

XXXX

Answered by Dr. Drkaushal85 (6 minutes later)

Brief Answer:
What was the need for chest x ray?

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
Since you are asymptomatic, no need to worry much.
It's good that you are not smoking.
Please let me know
1. What was the need for chest x ray?
2. Did you have symptoms at that time?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (2 minutes later)

One more question if you can answer that would be great:

As i have applied for NZ partnership visa and they have referred my medical reports to a medical assessor which was likely to happen due to below abnormalities in my chest x-ray:

1. Evidence of Tuberculosis- Present- Minimal density seen i Lt. apex.

2. Lung fields- Abnormal- Minimal density seen in Lt. apex.

Now immigration doctor is likely to ask for further tests to show him the TB is not active. what tests should i go for? Please advise.

Thanks,

XXXX

There were no symptoms at all. I just had to get my chest x-ray done due to immigration requirements.

Answered by Dr. Drkaushal85 (12 minutes later)

Brief Answer:
You will need bronchoscopy and XXXXXXX analysis.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
I am also doing physical fitness for immigration purpose in XXXXXXX Actually, I am consulting pulmonologist in civil hospital XXXXXXX
So I used to get these kind of cases.
You will need
1. Bronchoscopy with XXXXXXX (bronchoalveolar lavage) analysis
2. Routine blood tests like CBC, ESR
3. Mantoux test or TB gold test.
If all these are negative fir active tuberculosis, you will able to get clearance.
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (7 minutes later)

Thanks Doctor.

Where i can get these tests done from?

Do i also need a specialists report along with these tests to send them o immigration NZ?

Please advise.

Answered by Dr. Drkaushal85 (9 minutes later)

Brief Answer:
Where do you live? Are you staying in India?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Better not to take get done from substandard laboratory.
Actually, there are specific laboratory and hospital for immigration purpose for each country.
For CBC, ESR, TB gold, you need to visit laboratory.
For bronchoscopy and XXXXXXX you need to consult pulmonologist (lung specialist).
So please let me know
1. Where do you live?
2. Are you staying in India?
Please let me know these things, so that I can guide you about laboratory and hospital which are authorized by New Zealand immigration office.
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (2 minutes later)

Yes i am staying in Moga(near Ludhiana), XXXXXXX XXXXXXX

Answered by Dr. Drkaushal85 (4 minutes later)

Brief Answer:
You should consult in XXXXXXX XXXXXXX or PGI XXXXXXX

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
So you are staying in northern part of XXXXXXX
There are two recognized, authorized hospitals for New Zealand immigration in North XXXXXXX
1. XXXXXXX (All XXXXXXX Institute of Medical Sciences), XXXXXXX
2. PGI (Post graduate Institute) XXXXXXX
You can visit either of them, which one is nearer today you.
Both are recognized center.
Consult in pulmonary medicine department and discuss all these.
Your work willing done.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (2 minutes later)

Hello Doctor,

Is below the correct test i should go for:

QUANTIFERON-TB GOLD ; GAMMA INTERFERON

Please advise.

Answered by Dr. Drkaushal85 (5 minutes later)

Brief Answer:
Yes, both are same.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
Yes, both the tests are same.
No difference except names.
You can for either of them.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (3 minutes later)

Shall i also go for below test:

CULTURE, AFB (MYCOBACTERIUM), RAPID

Please advise.

Answered by Dr. Drkaushal85 (3 minutes later)

Brief Answer:
Culture from which tissue?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
For culture, you will need specimen.
So please let me know from which specimen you do culture?
I mean you are talking about which culture? Blood, sputum, BAL?
Please reply me answers of above asked questions, so that I can guide you better.
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (2 minutes later)

Blood. Is it going to be beneficial?

Answered by Dr. Drkaushal85 (7 minutes later)

Brief Answer:
No this is not at all beneficial.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
Blood culture for AFB is not at all beneficial.
Who told you so?
Is it mentioned in your immigration form?
Was it suggested by your doctor?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (5 minutes later)

Thanks. No,No one told me. I just heard that immigration is likely to ask for culture test which takes 6 weeks to be finalized.

Answered by Dr. Drkaushal85 (5 minutes later)

Brief Answer:
It depends on bronchoscopy findings.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Whether to send forum culture or not, depends on bronchoscopy findings.
Usually XXXXXXX culture is preferred fir this.
And now a days newer culture media are available which gives result in 12 days.
Liquid culture is rapid and highly accurate.
So consult pulmonologist in either PGI XXXXXXX or XXXXXXX XXXXXXX and get done bronchoscopy first.
If they need further diagnostic test then ask for liquid culture as it is fast.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (3 minutes later)

I have attached the CT scan report. Kindly have a look.

Answered by Dr. Drkaushal85 (10 minutes later)

Brief Answer:
They won't go for XXXXXXX or culture.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
I have gone through the report you have attached.
This is not active tuberculosis or any other lung infection.
This is sequele of previous lung insult (unknown).
I don't think they will go for XXXXXXX or culture.
They will mostly perform check bronchoscopy and give you clearance.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (1 hour later)

But i have not submitted this report to immigration which i sent to you. I have only submitted the x-ray which shows below concerns:

1. Evidence of Tuberculosis- Present- Minimal density seen i Lt. apex.

2. Lung fields- Abnormal- Minimal density seen in Lt. apex.

Please advise what kind of further tests immigration may ask for?

Answered by Dr. Drkaushal85 (7 minutes later)

Brief Answer:
They will ask for pulmonologist consultation to rule out active infection.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
OK, so immigration will ask for pulmonologist consultation to rule out active lung infection like tuberculosis.
Did you go through any blood reports?
Did you submitted them?
Please reply me answers of above asked questions, so that I can guide you better.
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar