Pulmonary Fibrosis

Mild Fibrosis

09/10/2009

Question:

Hi Doctor: I am a Stage I Breast Cancer patient in remission with CMF Chemo given and no Radio. CT Scan with contrast on Oct. 2008 showed an oppacity that later with Lung Asp. Biopsy showed not malignancy. Follow Up CT Scan two weeks ago shows "Associated increased interstitial markings in both bases with mild pleural thickening in the right representing changes related to interstitial fibrosis" No malignancy. I don`t have short of breath or cought. I was a heavy smoker until they found the Breast tumor Feb 08. My question to you: If the Fibrosis trigger was the Cigarrette and I stopped smoking and if it was the Chemo that I stopped taking or a combination of both, what are my chances with this new condition on my lungs? Thanks!

Answer:

There are certain varieties of interstitial lung disease that can develop from smoking including desquamative interstitial pneumonitis and respiratory bronchiolitis interstitial lung disease. Both of these tend to stabilize or improve with smoking cessation.
Radiation to the chest is an important cause of interstitial lung disease and the chemotherapy that you received can rarely cause interstitial disease. Lastly, infection can sometimes resemble interstitial lung disease on chest CT scans.

Your situation is complex enough that consultation with a pulmonologist may be necessary to get all of the answers you need in your particular situation.

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Response by:

James N. Allen, Jr., MD
Professor - Clinical
Pulmonary, Allergy, Critical Care & Sleep Medicine
Department of Internal Medicine
College of Medicine
The Ohio State University