More questions after the doctors visit

[orebro]

My wife is 51 years old, active and healthy, never smoked or worked in an area harmful to the lungs. She has had a cough for about the past 8 weeks which seem to have started with chest tightness(she had same cough last winter). She had a chest x-ray and a visit with a Pulmonologist. The Doctor said she had white lines or streaks in both lungs and maybe more in the lower area. He told her to wait until mid January when she would be feeling better (from the cough) and he would probably do a CT scan.

Well my wife is over her cough and she had the CT done and the pulmonologist said she had some fibrosis and maybe something else. After the CT she had a pulmonary function test done (it was normal) before our visit with the pulmonologist. We also had a chest  x-ray my wife had taken a few years ago with us so he might compare it with this latest one. On our visit with the doctor he said he didn't think it was anything to worry about and to come back in six months for another CT scan. I ask him if it could be hypersensitivity pneumonitis? He said no..and he never explained what the "white lines, streaks or something else" was.  Well we left with many questions. We live in Colorado so we are going to try and make it to NJ in Denver.

Do you think this could be the early stage of IPF?

Thanks so much for your time and helping us on this forum!

[National Jewish Health]

Your wife may have asthma and that could be responsible for the lingering cough, following what may have been an ordinary bout of acute viral bronchitis.  "The white lines or streaks" could be a sign of idiopathic pulmonary fibrosis (IPF).  Given the normal pulmonary function tests (PFTs), that diagnosis is unlikely and would be even more so, if some or all of the white lines were present on the x-ray taken a few years ago.  I would not jump to the conclusion that this is IPF.  The "lines" of IPF are characteristically in the periphery of the lung, with sparing of central lung tissue, especially in the early stages.

The pulmonary specialist is probably right, in not thinking that "...it was anything to worry about."  But, he/she should be able to give you a better idea of what these findings might indicate.  What you describe does not suggest hypersensitivity pneumonitis (HP).

You should request the official interpretation of your wife’s CT scan, from the doctor or from the radiology department.  You should request that it be interpreted by a specialist in chest radiology, if there is one, where the CT scan was done.

You would probably do well to await another CT scan, if the cough begins to subside.  If it doesn't soon or if you are anxious to know for sure what, if anything is going on, you would do well to schedule an evaluation at National Jewish Medical and Research Center by completing the online patient pre-registration form at http://www.nationaljewish.org/patient-info/become/index.aspx or call LUNG LINE® at (800) 222 LUNG (5864).

Good luck

[orebro]

Thank You!!

We have an evaluation at National Jewish Medical in Denver in Feb.

Appreciate your work here :)