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Sunday, March 9, 2014
I recently had a chest x-ray for a pre-employment physical. The results stated that there was a vague reticular-nodular infiltrate involving the right upper lung. The technician stated "I do not have a previous radiogragh for comparison to see if this is acute or cronic in nature. I will recommend a CT exam for further definition." What is a reticular-nodular infiltrate, and should I be worried?
Reticular (small lines) nodular (small spots) infiltrates can be seen with a large variety of diseases including scars (from previous pneumonia or previous tuberculosis), infection, interstitial lung disease, or cancer. The first step is to obtain old x-rays to see if the abnormality has been present for at least 2 years; if so, then active infection or cancer is very unlikely. A CT scan can help clarify the nature of the infiltrate. In the upper lobe, previous tuberculosis is a particular concern and so many physicians will order a TB skin test as part of the initial evaluation as well.
James N Allen, Jr, MD
Clinical Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University