What Does This Chest CT Scan Report Indicate?

Question : I am a 63 year old Caucasian female. My family history includes a father and brother who both passed away from Pulmonary Fibrosis. I recently went to a pulmonologist MD for a check up only. He had me take a breathing test and a chest x-ray. The first part of the breathing exam was normal, the second part of the breathing exam showed I was not expelling air up to par. He listened to my lungs with the stethacope and all sounded okay. The chest x-ray was normal. Due to my family history he had me go for a CT Scan of the Chest (without IV Contrast). The findings are: "The lungs are slightly hyperinflated. There is diffuse interstitial disease throughout both lungs most consistent with chronic fibrotic change. No alveolar edema or infiltrate. No mass or metastatic disease. There is no central bronchial abnormality. No hilar or mediastinal mass or adenopathy. IMPRESSION: Interstitial parenchymal disease probably chronic. No evidence of alveolar edema or infiltrate. My doctor wants me to come back in 6 months of a chest X-ray. Does this mean I have PF? Could this just be a long-standing issue? I'm not sure what to think or expect or what is anticipated by my MD. (FYI, not sure this has anything to do with anything, but when I was a child, my family lived about one-hour drive from Three Mile Island when the nuclear accident happened years ago. Also, both my parents were smokers until I was about 11 years old. I never smoked.)

Thank you for your reply.

Yes, you may ask me further questions about my CT scan.

Just as an FYI, the CT scan of my chest was done approximately 2-1/2 weeks ago, as was the pulmonary function (breathing) test, and the chest x-ray. My pulse ox reading, also was 98. My last blood pressure readings were something like 112/70, which is about normal for me.

Also, in response to your question if I am having any symptoms, the answer is no I have not had any significantly noticeable symptoms. My doctor asked me if I have any difficulty breathing during walking, etc. I told him I have not and had recently taken a long walk throughout my neighborhood, which has many hills and I was walking faster and was less tired than my 9 year old (adopted) son and his 9 year old friend.

I do have a sedentary job where I sit for almost 12 hours at a time during my shift; however, and feel as though I need to add some exercise into my daily routine.

I also do notice since my appointment with the pulmonologist that I try to take extra deep breathes more frequently, but seem only to be able to accomplish this every one out of three attempts. I keep thinking this might be due more to anxiety from getting the CT results than anything else at this time, since when I think back as long as I can remember I have always had a similar reaction when trying to take a deep breathe.

Below is some of my medical history ....

I was recently diagnosed with thyroid nodules. I think that the thyroid problem caused me to gain weight. I now stand 5'5" tall and weigh 147 pounds. Most of my life I was very thin and weighed no more than 112 to 120 pounds. What brought me to the endocrinologist was I would cough a lot at the feeling that there was something in my throat. One of the nodules was aspirated. I was told to follow up in 6 months. I have changed some things in my diet and rarely cough any more, since I do not feel the nodule pressing into my throat any longer.

I was also recently diagnosed, by a rheumatologist, with peripheral neuropathy approximately one year ago after finding that my legs felt heavy and weak. After my labs came back normal, and then other testing was done, I was prescribed Vitamin D3 (5,000 iu) and B Complex. Taking these vitamin supplements has helped me and I feel normal, again.

I rarely ever take any other supplement and I am not on any medication at this time.

Also, I recently had a general workup by a cardiologist, including labs, sleep apnea test and a stress test. The doctor told me I am in the "top 1% of people with a healthy heart," although I learned I do have a little sleep apnea and use a second pillow when lying down at night. I was told there was no need for any follow up.

I go annually or biannually to a gastroenterologist for a colonoscopy, as a follow up for colon cancer, T2, which was diagnosed in 1996. At the time of diagnosis, I had a colon resection, but no chemo therapy. I also have annual labs done to check my liver and all has been negative since my original diagnosis and surgery.

I also have a history of kidney stones.

I eat a fairly healthy diet and generally feel in very good health.

Some questions and comments are below ....

Doctor Bhavsar, why would the chest x-ray come back normal? Are the results of the CT Scan (Chest) significant for my future? I do plan to follow up with the pulmonologist in 6 months for the pulmonary function test. I remember when I had the testing done that I told the doctor that I felt as though I had not done the second part of the test correctly at the time and asked the respiratory therapist if I could retake it, but he did not permit me to do so. What I mean is that when I went to expel I felt I stopped before I should have and so the results would not have been accurate.

Thank you, again. I await your response.

Dr. Bhavsar, thank you for your reply. ...

To answer your questions:

1. Do I have any pets? Yes, I have two dogs and one cat. They are all "indoor/outdoor" pets. The dogs are generally in one gated room, while the cat is usually inside for several hours during the day and evening and outside the rest of the time.

2. Do I have any workplace chemical exposure? No, I do not. I have worked in a hospital for approximately 20+ years as a psychotherapist. At present, I work in a building separate from the main hospitals where my patients are assessed by a tele-monitor system.

Again, I bring you back to my concern...Is what is presently showing on my CT Scan something that can remain the same or will it ultimately progress into something much worse? Of course, no one can predict the future, but I do have a reason for asking, which is to begin preparing for my young, adopted son's future, as I have no family. I do currently respect my current pulmonologist (I've worked with him for many years at the hospital, he has an excellent reputation, and he has been named one of the top pulmonologists in the U.S.); however, I can't help but think he might be "protective" of me at this time when I need to know what to expect. I appreciate your candid and open response in this regard.

Thank you.

Dr. Bhavsar,

Thank you so much for your response and I will follow up regarding the allergy testing, as you suggest.

Also, please rest assured that I was not questioning you regarding my pulmonologist. I was actually just making a comment that since he has known me for so long he may have intentionally been holding back negative information until he knew something further because he did not want to worry me. This is my reason for seeking an unbiased professional opinion from someone such as yourself and I am very grateful you have been here for me on this site.

Regarding your comments, I have have found them to be consistent and thoughtful and I greatly appreciate your service. I will take them to heart.

Thank you, again, very much.