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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 56055
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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I recently had a repeat chest x-ray after a bout of pneumonia.

Resolved Question:

I recently had a repeat chest x-ray after a bout of pneumonia. The new x-ray results read:
"As noted in the exam of 02/06/12, the patient has peribronchial cuffing and diffuse miliary nodularity. Examination 02/06/12 also displayed a retrocardiac infiltrate, PA view, again displays a peribronchial cuffing and miliary nodularity. There has been no significant progression in these findings. In lateral view, which displayed a retrocardiac infiltrate, there is some improvgement. The area is still not completely clear. " Now the doctor wants to do a CT scan with dye injection - I am not too keen on this. It is important to note I have noted scar tissue from previous bouts with pneumonia as a child and adult. I feel fine, no breathing problems, can run up and down three flights of stairs all day long and not get winded. I am a singer and can hold my notes fine AND I can walk and talk with no problem. To me it sounds like I have improved. It was only a week later the second xray was done from the diagnosis. I would love to know 1) what does this radiology report mean? 2) Is the CT scan and Dye injection into my body really necessary? 3) Why would this doctor want to do it, what is she looking for? 4) Also should be noted the Radiologist is a Kaiser radiologist, do not even know if it is a tech or an MD who read this. Just want some more info before I subject my body to having foreign crap put in it. Please help.
Thank you -- Sunny
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. Thomas, MD replied 2 years ago.
Hello
peribronchial cuffing is fluid around the bronchioles and it can happen in pneumonia.
The infiltrate is consistent with pneumonia.
The nodularity is also non-specific can represent infection, tuburculosis, autoimmune diseases..etc.....
I suggest that the radiologist is telling your doc that this is unusual for pneumonia, and hence the need for a CT.

I would find the summary of the report, also called impression and see what the radiologist is suggesting and why.

Let me know if you have further questions, details or need clarification, just use reply.......

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Customer: replied 2 years ago.
I have asked my doctor for the "summary" but have received no response. She just insists here way or the highway. I am not convinced as I have a real problem with tests of any kind that I have to have dye injected into my body. I simply do not see what they expect to find and if they do find it what they would do about it after they find it. Because I can guarantee there will be no cutting. The other thing that bothers me about this whole scenario is that I feel absolutely fine, like I said in my first email. I already know that several times the "old scar tissue" has caused concern and since I have not symptoms of any kind, meaning any breathing problems, do not understand why they would not want to do another xray first. The radiologist's report showed some improvement even at that early juncture after the most recent bout with Pneumonia. Can you shed any light on these aspects? Something that might help me understand why and what?
Expert:  Dr. Thomas, MD replied 2 years ago.
No
I can not second guess your doctor.
What I would do in this situation is ask to see a pulmonologist for pulmonary function testing instead.
This would indicate if there is chronic lung disease.
In addition the pulmonologist can tell you if you need the imaging based on discussion with the radiologist..as your doc apparently can not.

It is not an emergency, and there is no problem in a few week delay.


Please Click Accept to give answer credit so I am compensated for time and expertise. Come back if needed. Bonuses and positive feedback most helpful. Answers for informational purposes only, not to replace your physician advice or visit.

Future questions? Ask for DrThomas in the question title or see my profile to request me. Save my profile to your browser favorites.

Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 56055
Experience: Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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