1. < Lung Health

Can someone help with understanding test (PFT) results?

Posted by yoyo548 @yoyo548, May 12 2:16pm

Have had shortness of breath and cheast pain for over 6 months. PFT was done was diagnosed with sever asthma uncontrolled ( never had asthma before) previously CT showed focal TIB new CT shows scattered TIB. BAL negative.

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Mentor
Sue, Volunteer Mentor | @sueinmn | May 12 5:31pm

@yoyo548 Welcome to Mayo Connect. Sometimes I think on-line access to our medical records, before our care team has had time to review test results and contact us, is a mixed blessing.

For those of us with on-going health concerns, who are familiar with their condition and the related jargon, it can provide relief knowing there is no change, or even improvement. For those undergoing diagnostic testing, who don't have familiarity with the terminology used by radiologists to communicate with the provider, it can cause confusion and anxiety.

Here is my layperson interpretation for you. The asthma diagnosis was based on your current pulmonary function, but the doctor was also probably confused by the sudden onset, so ordered a CT scan to gather more information.

Now to the CT - the radiologist's apparent diagnosis is bronchiolitis, which is a lung infection, usually viral in nature, that may begin with a cold or respiratory virus that hangs on and worsens. One symptom is wheezing, another is shortness of breath. This may have led to the doctor's preliminary diagnosis of asthma.

The terms "tree-in-bud" "opacities" and "mosaic attenuation" all suggest areas of congestion (mucus build-up or trapped liquid) or inflammation. In bronchiolitis, these will usually go away as the virus leaves your lungs. If symptoms are severe or persistent, your doctor may prescribe an inhaler or nebulizer to ease your breathing and a steroid (inhaled or oral) to reduce swelling of the airways.

The good news is bronchiolitis clears up - here's what Mayo Clinic has to say about it:
https://www.mayoclinic.org/diseases-conditions/bronchiolitis/symptoms-causes/syc-20351565
Just so you know, a common virus called RSV often causes this. It is great that you sought care - untreated it may turn into pneumonia in children, older adults, and people with compromised immune systems. If that is what you have, there is a vaccine to prevent it in the future.

Please let me know what the doctor says about the test results. You can do that simply by replying to my comment.
I hope you are feeling better!
Sue
PS If this is the final diagnosis, be sure to get a new PFT in 2-3 months. They may be able to remove the "asthma" diagnosis from your charts, and allow you to discontinue any asthma meds.

But, once you have had a complication like this, be especially vigilant if you get another respiratory infection.

REPLY
1 reply
yoyo548 | @yoyo548 | May 13 8:33am
In reply to @sueinmn "@yoyo548 Welcome to Mayo Connect. Sometimes I think on-line access to our medical records, before our..." + (show)
@sueinmn

@yoyo548 Welcome to Mayo Connect. Sometimes I think on-line access to our medical records, before our care team has had time to review test results and contact us, is a mixed blessing.

For those of us with on-going health concerns, who are familiar with their condition and the related jargon, it can provide relief knowing there is no change, or even improvement. For those undergoing diagnostic testing, who don't have familiarity with the terminology used by radiologists to communicate with the provider, it can cause confusion and anxiety.

Here is my layperson interpretation for you. The asthma diagnosis was based on your current pulmonary function, but the doctor was also probably confused by the sudden onset, so ordered a CT scan to gather more information.

Now to the CT - the radiologist's apparent diagnosis is bronchiolitis, which is a lung infection, usually viral in nature, that may begin with a cold or respiratory virus that hangs on and worsens. One symptom is wheezing, another is shortness of breath. This may have led to the doctor's preliminary diagnosis of asthma.

The terms "tree-in-bud" "opacities" and "mosaic attenuation" all suggest areas of congestion (mucus build-up or trapped liquid) or inflammation. In bronchiolitis, these will usually go away as the virus leaves your lungs. If symptoms are severe or persistent, your doctor may prescribe an inhaler or nebulizer to ease your breathing and a steroid (inhaled or oral) to reduce swelling of the airways.

The good news is bronchiolitis clears up - here's what Mayo Clinic has to say about it:
https://www.mayoclinic.org/diseases-conditions/bronchiolitis/symptoms-causes/syc-20351565
Just so you know, a common virus called RSV often causes this. It is great that you sought care - untreated it may turn into pneumonia in children, older adults, and people with compromised immune systems. If that is what you have, there is a vaccine to prevent it in the future.

Please let me know what the doctor says about the test results. You can do that simply by replying to my comment.
I hope you are feeling better!
Sue
PS If this is the final diagnosis, be sure to get a new PFT in 2-3 months. They may be able to remove the "asthma" diagnosis from your charts, and allow you to discontinue any asthma meds.

But, once you have had a complication like this, be especially vigilant if you get another respiratory infection.

Jump to this post

Thank you for replying.
An infection was ruled out with bronchoscopy BAL negative for infection. Second PFT showed significant changes. Tree in bud is now spreading.
This CT was from a second opinion. Only changes from previous ct was from focal to scattered TIB and Mild Mosic to Moderate.

REPLY
1 reply
vic83 | @vic83 | May 13 9:30am
In reply to @yoyo548 "Thank you for replying. An infection was ruled out with bronchoscopy BAL negative for infection. Second..." + (show)
@yoyo548

Thank you for replying.
An infection was ruled out with bronchoscopy BAL negative for infection. Second PFT showed significant changes. Tree in bud is now spreading.
This CT was from a second opinion. Only changes from previous ct was from focal to scattered TIB and Mild Mosic to Moderate.

Jump to this post

Regarding understanding PFT results, I found this brochure to be helpful (from Pulmonary Fibrosis Foundation). Go to page 20 and see explanations.
https://www.pulmonaryfibrosis.org/docs/default-source/programs/educational-materials/pf-information-guides/pf-info-guide.pdf

REPLY
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