When my mother went to the ER the second time during a bout with pneumonia (she had vomited and complained of faintness and had clammy skin), a CT scan was ordered due to an elevated D-dimer (what’s this?).
The ER doctor said that the CAT scan showed that the pneumonia was gone (though my mother still had a bad cough).
The doctor then said something like, “The scan also shows that you have inflammatory lung disease, and this is not part of the pneumonia, which you no longer have.”
Prior to the CT result, my mother had a chest X ray that the doctor said still showed some pneumonia. So I asked, “Then what was on the chest X ray that you said a while ago showed some pneumonia?”
The doctor replied, “That’s scar tissue from the pneumonia. We know now from the CT scan that the pneumonia’s gone. Pneumonia tends to show on an image in a lobe of the lung, but the inflammatory lung disease shows as diffuse. I recommend a follow-up with your regular doctor or a pulmonologist to have your lung function checked.”
I asked the doctor for a more definitive explanation of this “inflammatory lung disease,” but she said it was difficult to be more descriptive at this point, and that’s why the follow-up was necessary.
I asked if this inflammatory lung disease could be caused by the pneumonia. She said no, pneumonia does not cause inflammatory lung disease.
I left the ER thinking that my mother possibly had some early stage lung disease! What was this inflammatory lung disease?
I spent a good amount of time researching “inflammatory lung disease” on the Web. Nothing definitive came up other than this term sometimes primarily refers to asthma, emphysema and chronic obstructive pulmonary disease – all of which produce symptoms, and my mother did not have these symptoms.
Type “inflammatory lung disease” into the search engine and you get links to information on lung disease and inflammatory bowel disease.
There was also a link to a medical journal article titled “Adenocarcinoma of the lung mimicking inflammatory lung disease.” Adenocarcinoma is cancer! Another site said that inflammatory lung disease could refer to one of about 200 conditions.
Next day I contacted my mother’s doctor’s office and spoke to the nurse, and learned that the preliminary report of the CT scan, sent by the emergency room doctor, stated, “Granulatoma with change and ground glass opacities.
It took me a while, but I finally recalled that several years ago, a “granuloma” was noted on a chest X ray of my mother.
A granuloma is a dense collection of scar tissue that indicates previous infection, and is harmless. But what was this “ground glass opacities”?
I did a search and found a fantastic site called appliedradiology.com. The article on the site is all about what ground glass opacities on a CT scan mean; it’s written by two doctors and based upon 43 medical journal reports. Can’t get better than that!
The article says that pneumonia CAN cause diffuse-pattern ground glass opacities (GGO) on a CT scan! It also says that GGO can result from an error in image interpretation, plus unreliable aspects of the imaging technology itself!
GGO can also appear as a result of normal breathing! The report says that GGO is a “nonspecific radiologic finding” that has a lengthy list of causes.
I thought, This sounds like another one of those incidents where a scan picks something up that can’t be defined, and follow-up testing is warranted.
This happened to me years ago when I had an ovarian “cyst” that turned out to be a harmless follicle that used to contain an egg!
My mother had the follow-up and the doctor apparently didn’t even mention the “ground glass opacities,” and said she was awaiting the more detailed report from the ER.
A phone appointment with my mother was made for two weeks later to discuss that more detailed report.
Two weeks later my mother’s doctor called and told her everything was normal, and that no further follow-ups were necessary.
Be leery and inquisitive if a doctor tells you that you have “inflammatory lung disease.”
Sources:
erj.ersjournals.com/content/24/3/502.full
ehow.com/about_5489647_inflammatory-lung-disease.html
medicalcenter.osu.edu/patientcare/healthcare_services/lung_diseases/lung/interstitiallung/Pages/index.aspx
mayoclinic.com/health/granuloma/AN00830
appliedradiology.com/Issues/1998/12/Articles/Ground-glass-opacity-on-CT-scanning-of-the-chest–What-does-it-mean-.aspx
