Hi, Thanks for writing in. I think you are talking about your Chest CTscan with contrast, done for investigating a cause of your shortness of breath and cough. It is clear that you have had significant occupational exposure to coal dust for almost 37 years. Such long exposure surely has affected your lungs. Through the years, very fine coal dust particles have entered your airway and got deposited in the alveoli (tiniest portion of lungs called lung sacs where gas exchange takes place). This has caused chronic injury to the lungs and led to fibrotic changes (pneumoconiosis). Also as coal dust is recognized as foreign element by the body, there has been lymphnode swelling in the space between lungs and adjacent to the heart (mediastinum). These changes predispose a person to shortness of breath and cough. Though the changes in your lung are not totally reversible, you could delay further damage by taking medications. There is no sign of cancer, however pneumoconiosis itself need to be controlled in your situation. Please visit your doctor regularly and avoid further exposure to coal dust and smoke. Hope this helps.