Regarding "After my latest every 3 months follow up CT for multi focal adenocarcinoma, added radiation fibrosis and emphysema. Known COPD, never seen either on my CT results."
I too have multifocal adenocarcinoma, and I have had about 10 CT scans in the last 2 years. I notice a significant difference in style between one Radiologist report and another when discussing my multiple nodules.
I know my doctors like to look at the actual scan on their monitors and not the report. But I only have these reports and I am amazed there is not a consistent format for discussing such nodules.
Regarding other lung issues, my CT scans report other lung issues such as interstitial disease, and pulmonary fibrosis. I had recent radiation-induced pneumonitis. Have you had recent radiation treatment to your lungs?

Since the scans pick up and report other things not related to my lungs, I have my PCP review, or I see a specialist in that area if I have concerns.