COPD

[Guest]

After experiencing shortness of breath and chest pains I received 2 different diagnosis' from 2 Pulmonary specialist. One said I had Emphysema and the other said it was probably anxiety and I did not have emphysema I have received copies of the consultation reports for both CT scans and I am unable to understand them. Can you please translate?

#1 Lungs demonstrate diffuse emphysematous changes without any focal bullous changes. There are no infiltrates or mass effects involving the pulmonary parenchyma or pleura. No axillary adenopathy. No mediastinal adenopathy. No significant focal abnormalitites demonstrated on CT scan of the chest.

#2 No active infiltrate or pleural effusion is noted. No fibrosis is identified. No mediastinal soft tissue mass or lymphadenopathy is noted. No significant abnormality of the lungs. Pleura or mediastinum is noted on CT evaluation.

Thank you in advance.
Erica

[Guest]

This is confusing as one ct scan report comments on the presence of emphysema and the other doesn't. How far apart were they taken and did you get pulmonary function testing? Do you or did you ever smoke? these are important parts of determining whether you have emphysemna. The rest of the ct reports are normal.
[quote] After experiencing shortness of breath and chest pains I received 2 different diagnosis' from 2 Pulmonary specialist. One said I had Emphysema and the other said it was probably anxiety and I did not have emphysema... [/quote]

[Guest]

The CT scans were taking less than 1 month apart. I am 36 and I smoked for a total of 16 years. I have had two PFT taken less than 1 month apart from each other also. I had an FEV1/FVC of 79% on one and a FEV1/FVC of 86% on the second PFT. I have no other medical conditions and have been pretty healthy all my life.

Thank you,
Erica
[quote] This is confusing as one ct scan report comments on the presence of emphysema and the other doesn't. How far apart were they taken and did you get pulmonary function testing... [/quote]

[Guest]

although it is possible that you have emphysema, i cannot say that for sure. do you know the DLCO on the PFT's? That is helpful for diagnosing emphysema as are values for total lung volume and residual volume. In any event, the normal ct scan is encouraging that the first one was incorrect.
[quote] The CT scans were taking less than 1 month apart. I am 36 and I smoked for a total of 16 years... [/quote]

[Guest]

They did not measure DLCO on either test nor did they do additional testing after using an inhaler.

Ref Pre Meas Pre % Ref
TLC liters 4.73 5.55 118
RV liters 1.38 1.60 116
RV/TLC % 29 29
FRC Dil 2.58 3.38 131

I had my first shortness of breath experience at the age of 21. It was brief and the weather was hot and humid. From the age of 21 until recently I have had 1/2 dz similar experiences with SOB all during hot humid days. Sometimes several years would go by with no SOB at all. My SOB is more severe now, not to the point it limits my activities but I experience it on a daily basis since mid April. Occasionally I get a sharp pain on the left side of my chest and on inahlation my chest feels tight. My nose is constantly dry and stuffy. I have no wheezing, coughing or congestion. I have and 2 echocardiograms and everything checked out fine except for mild mitral regurgitation and mild tricuspid regurgitation. I am told this is nothing to be concerned about. My father was diagnosed with emphysema at the age of 28. We were both tested for Alpha 1 and the results were negative.
One ct scan says "pleura or mediastinum is noted," what does this mean?

With 2 conflicting diagnosis I am confused and anxious as to what my health situation really is. Your help is greatly appreciated.

Thank you,
Erica

[quote] although it is possible that you have emphysema, i cannot say that for sure. do you know the DLCO on the PFT's... [/quote]

[Guest]

I can't say for sure but the information you have given me is not consistant with emphysema. the negative alpha 1 antitrypsin level is good but did your father smoke? If not he may have had a rare cause of emphysema. Were the ct scans taken at the same place? If so, you could ask the radiologists to look at both and give you an opinion. Emphysema would not develop or resolve in 1 month so they must have an explanation for the two readings.
[quote] They did not measure DLCO on either test nor did they do additional testing after using an inhaler.

Ref Pre Meas Pre % Ref
TLC liters 4... [/quote]