Upper Lung Predominant Fibrosis
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- čas přidán 14. 06. 2024
- Here's my differential for upper lung predominant pulmonary fibrosis:
SHORTI:
Sarcoid
Hypersensitivity pneumonitis (chronic)
Occupational pneumoconioses (silicosis, coal worker's, berylliosis)
Radiation fibrosis
TB and fungus
Idiopathic pleuroparenchymal fibroelastosis
Textbooks I like for chest radiology-
Med students and all residents: Felson’s Principles of Chest Roentgenology
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Radiology residents: Thoracic Imaging: Pulmonary and Cardiovascular Radiology
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Thoracic radiology fellows: Muller’s Imaging of the Chest: Expert Radiology Series
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Thank you so much Dr.Rishi Aggarwal for your short but highly informative video.
crystal clear. Thanks!
Excellent presentation
Thank you so much!
Thank you so much! I learned a lot from your channel bb
Cool,thanks
Thank you so much sir
Excellent 👌 thanks 🙏
❤thank you ❤ well explained 🎉
Thx you
Very good
Sir patchy area of ground glass opacification predominantly involving the peripheral sub pleural zones of bilateral lung. Band atelectasis seen involving bilateral lung field,sir isme fibrosis h kya
0:10 UPPER LUNG PREDOMINANT FIBROSIS 1:17 SARCOID 1:58 HYPERSENSITIVITY PNEUMONITIS 4:35 OCCUPATIONAL (PROGRESSIVE MASSIVE FIBROSIS) 6:51 RADIATION FIBROSIS 9:16 TB/FUNGUS 10:47 IDIOPATHIC PLEUROPARENCHYMAL FIBROELASTOSIS
My gmot po b yn
Great presentation. Question - if the patient had chronic HP with fibrotic changes, would this only be seen on an HRCT or would you see these changes on a regular ct and/or chest x ray? Thanks.
If there is fibrosis you would also see the changes on a regular CT. You may not see the changes on a chest x-ray though, unless the fibrosis were severe enough. Mild fibrosis is easily missed on chest x-ray.
good evening, I am with mixed chronic bronchitis, given CT tests highlights, fibrotic changes pleuro pulmonary lungs you feel stiff swollen chest and hard how will you write if it is idiopathic?
Hi Dr. Is there any proper diagnosis of ippfe?
Few fibrotic in inferior lingula segment is dangerous?
Dr.Rishi, thank you for your nice Video s. Two years ago upon taking CT for broken rib, Radiologist thought he saw early stage of Fibrosis and Lung surgeon confirmed it wasn't Fibrosis and it was (abration from spine rubbing) lesions. After two years, from yesterday's f (CT taken while patient facing face down) confirmed early stage Fibrosis. It's from European Nr 1 Heidelberg Lung Klinik. For two years no growth....Could it be something else than Fibrosis???
it is common to have fibrosis in the right lower lobe, next to the spine. if it has not changed in 2 years, it is a good sign that it is fibrosis.
fiberotic opacity with volume loss in left upper zone with pulled up left hillum plz tell me any problem
Thanks for this nice presentation.
I would like to ask about the few fibrotic bands and pleural based nodules sometimes I detect mainly at apices or middle lobe (mostly) with no history of chronic lung disease or Tb, just incedental findings.
How can I interpret those findings? .
Fibrotic bands usually happen in areas of old infection. Pleural based nodules are usually benign, especially if they are triangular or square in shape. Most of the time, they are intrapulmonary lymph nodes.
@@ThoracicRadiology thank you very much
Thanks to this short presentation I appreciate, I would like to ask about the finding of my patient, Minimal left apical fibrosis
What's the meaning of fibroreticular upper lobes densities.
Hello Doctor! Great video!! Would you also include Ankylosing spondylitis as a differential for upper lung predominant fibrosis? Thank you
Yes I would include it too. Thanks for your suggestion. Kind of rare so that's why I didn't include it in my mnemonic. Thx!
@@ThoracicRadiology thick walled cavitary lesion measuring (2.2×2.5 cm ) at apical segment of right upper lobe with fibronodular lesions at all segments of right upper lobe
Pls tell me is this serious case and dangerous disease
This is for 17 years girl .. she is facing weightloss
yes I certainly am with bpoc pulmonary emphysema and pleural fibrosis plus ankylosing spondylitis lung fibrosis kidney heart, uveitis eye blindness and I'm serious
@@jagadeeshdadi7227 location and age goes most probably with TB, which is treatable entity. Which her wellness and speedy recovery.
Hello Dr.rishi ,,I been x-ray test din result is
Fibrosis in the left upper lung field?
What they mean?
dr i have a question my wife had covid 19 3 weeks ago now she have bad cough we went to take a chest x ray on the description is says theres coarsening of the interstitial lung markings. then it said impression no active lung disease. am confused with results
When they say "no active lung disease" they mean that they don't see any new pneumonia. However, it sounds like there may be some lung fibrosis or other inflammation in the lung that can persist even after the COVID infection is over. I would recommend that your wife see a pulmonologist (lung doc). They may want to measure the lung function and maybe get a CT of the lungs.
Thank you for the informative lecture. A curious question unrelated to the topic. what would you comment the linear consolidations in the lung base in a patient undergoing non-lung-surgery?
Frequently after abdominal surgery patients get atelectasis at their lung bases, basically collapsed airspaces. Pain, shallow breathing, prolonged recumbent position are the typical causes. This eventually goes away as the patient recovers.
Dr any medicine?
My mother ct scan report is finding are suggestive of fibrosis changes along with bronchiectasis in the anterior and posterior segment of the left upper lobe possibly siquale of previous infective etiology.
According to this report please tell what disease name is exactly?
there is no exact name for this. it sounds like the radiologist thinks that it is scarring from a prior infection.
Hi Doctor thank you for the informative video. Sir my sister got diagnosed gallbladder cancer last year and doctor removed gallbladder and she had gone for chemotherapy as well and later in pet scan there are no cancer cells and now just for follow up doctor has done CT for her chest and stomach. The chest report is this CECT Chest findings reveal:
-Small fibroatelectatic bands in right middle lobe and dependent posterior part of bilateral lower lobes. Could you please suggest your opinion as she don't have any health issue now
Hi, sorry it is hard to say for sure if this is significant or not. I would ask her doctor to see if any follow up was recommended.
@@ThoracicRadiology thank you so much sir for your quick response. I really appreciate your time and response. Sir doctor has suggested follow up after 3 months and he said it's because of chemotherapy so nothing to worry and no medicine is required now. Will do all the test after 3 months. But after checking in Google we was just getting panic and she is just 33 year's old so we thought of taking second opinion. God bless you sir 🙏🙏 could you please confirm if any second opinion is required sir 🙏
Dr if the honeycombing is minimal right now , how long does it take to become very worse. My brother is suffering from Hypersensitivity Pneumonitis and we would like to know how long will it take to destroy the entire lung
It can be variable. First thing to do is try to find out what is causing the irritation in the lung. Is it mold or pet bird? Is he seeing a pulmonologist?
If i have a minimal fibrosis..the doctor give me authorize to work
Hello Doctor, Actually I have to ask regarding a CT findings: it says "Fibrotic bands in apical region". Few tiny calcified nodules are noted in bilateral lower lobes, suggestive of old granulomatous lesions. There is no other obvious lesion in the lung fields
I never had TB, pneumonia or covid symptoms, I do have frequent common cold and allergic from pollution/cold air/smoke/dust.
Have you seen these findings to Progress over a period of time in young adults or it stays the same ?
Hi, I'm general, these findings you mention are very common and do not typically progress. There are some granulomatous infections that you can have that show no symptoms, and they go away on their own.
@@ThoracicRadiologythanks for explaination, Dr. Rishi . I just got scared reading the word "fibrotic" as I never gone any infection or radiation therapy. Now bit relaxed 😌
And yes you're doing excellent work through this channel and helping many patients to distinguish their findings 😇
Hey.. I done hrct today because i have fungal infection on right chest..also had tissue biopsy at same side due to abcess. Hrct clinical impression said fibrotic strand is noted in right upper lobe..what does that mean?? Will it ever go away??
The abscess will go away if you are taking antibiotics. Some of the stuff around it will go away too. Fibrosis will not really go away completely, no. But if the rest of your lungs are normal, should be ok
Sir I have patchy fibroatelectic changes in bilateral upper lobes on CECT? Is that serious?
Can't say for sure. Sometimes it is no big deal but sometimes it can be serious. Need to ask your doc and/or the radiologist who read it.
Any treatments that can improve the symptoms and/or prognosis for patients with PPFE?
Sir focal fibrotic changes in left lobe of the lungs is serious or not plz reply. Spirometry test normal but shortness of breath.
fibrosis is a kind of scarring that can happen in the lung from a variety of reasons. if you feel short of breath, see if you can have a visit with a lung doctor.
is this curable doc? thank you doc
It depends on the cause. For example, if it is from infection, the infection can be cured but the fibrosis will always be there.
Hi I took CT scan for covid result came as there is no covid infection but it another minimal subplureal fibrosis I don’t what to do is this a serious problem?
can't say for sure. it may be something to keep an eye on or it may be totally harmless. i would ask your doctor bc it really depends on your medical situation.
Sir. How to know the exactly place to draw the line?
try to draw a line bisecting the right and left hila
My dad caught COVID 19 last July 2020 and got pneumonia, now he can’t breathe and Dr says he has pulmonary fibrosis, will it ever go away is there any cure? I’m just looking for any info to let my dad have some what of a normal life again. Thank you
I can't say for sure. If his difficulty breathing is from fibrosis, it probably won't improve too much. If it is from residual inflammation from the infection, it could get better. It also may be a combination. In other words he may have some room for improvement but not totally back to baseline.
@@ThoracicRadiology thanks so much for the feedback 🙏🏻
Sir I am 19 .i want to know the radiation dose of hrct of neck and thorax plain and contrast.
it is much lower than the amount of radiation somebody would get for the treatment of cancer. the amount of radiation from a chest CT and neck CT would not be able to cause lung fibrosis.
@@ThoracicRadiologyplease reply s
sir already I have fibrosis in both lungs.That s y I am asking what is the radiation dose given in my neck and thorax ct.
Treatment
Depends on the cause. Did your doctor figure out the cause?
Please make a video on IPF...
He has already made a video discussing UIP. Keep in mind that IPF is not a radiological but a clinical diagnosis that presents radiologicaly with the UIP pattern, which can also be seen in cases of connective tissue disorders, hypersensitivity pneumonitis or drug pneumotoxicity.
Hi, yes, there is a video I have up on the 4 features of ILD that I touch on UIP. I would take a look at that one. I do plan on making a video going over the ATS/ERS criteria for UIP, but I am still developing it. Jake is correct, IPF is a clinical diagnosis. Whereas the UIP pattern is a radiologic/histologic diagnosis. Thanks.
Multiple areas of groundglass opacities and consolidation with scattered areas of fibrosis in both lungs -CORADS 5: Typical COVID-19.
I’m recovered from COVID-19 but I’m worried weather I’m developing fibrosis r not, pls help dr in clarifying
CT severity score: 7/25-Mild.
The bronchioles are normal. No evidence of bronchiectasis.
No evidence of emphysema.
No evidence of pleural effusion.
No significant lymphadenopathy seen.
Trachea is normal in size and position.
Carina is normal.
Visualized spine appears normal. Liver shows diffuse hypoattenuation -Fatty changes. Spleen appears mildly enlarged.
Good pm. Sir I'm asking about fibrosis lung upper lobe this is a big problems or what.
Can't say for sure. It depends on the cause of the fibrosis.
@joel polinar I have to, base on my search, it's serious.
Hello if we have minimal fibrosis if there chances to work or not
@@ThoracicRadiology doc my gmot po ba yn saan pwd mgpcheck up at mgbasa ng ctscan