Pneumonitis, groundglass, consolidative opacities

barbojoy

Hello all.

I had a CT yesterday to evaluate a blood clot that I got from my port-a-cath. It is my3rd CT since December. They noted a non-cardiac finding: "new multifocal peribronchial groundglass and consolidative opacities in the upper left lobe which may represent multifocal infection or drug related pneumonitis." My radiation was 02/16/2022-03/16/2022. I noticed a dry cough that started on March 7th. I recall the date because it was after a VO2 stress test. It was really bad for a couple of days and then became milder. It still happened in the middle of the night sometimes and periodically during the day so I informed my RO about it April 18th. She ordered a chest Xray, which was negative, but prescribed steroids anyway to be on the safe side. I completed the steroids April 28th.

I've had worsening shortness of breath, dry cough, I'm exhausted and my appetite is low. I've also had some ongoing lower GI issues since chemo & general malaise. No fever.

The CT results auto-post to my hospital's patient portal, so I have not talked with any physicians yet, but obviously I am concerned.

I have a fluid-like lump on my chest that I showed my MO on 04/28 and she said she's going to order an ultrasound of the left chest and axilla - could be fluid.

The CT lung findings are also on the left (cancer) side. These findings were not present on my last CT which was March 29th, although they did not "bronchial wall thickening at the lung bases" on that scan- so this is a new and increasing problem.

I had DBIH radiation of the left chest wall, axilla and supraclavicular areas with bolus and booster. Seems like this is radiation-related pneumonitis but there is very little in the discussion forums about that. Anyone have experience pneumonitis so soon after radiation and based on the description from the radiologist that I posted above-- has anyone had procedures or tests that followed these types of findings?

Thanks in advance for your insights!

ratherbesailing

Barbojoy, I had pain on deep inspiration about a month after radiation, and CT also showed ground glass opacities, right along the radiation field. One doctor told me all radiation patients will have CT findings after radiation, and symptoms most often go away on their own. For those with persisting symptoms, steroids are often prescribed, also to prevent the post-radiation pneumonitis from developing into permanent fibrosis.

So, yes, pneumonitis is common soon after and not necessarily a permanent issue. But you do want to keep an eye on it to make certain it doesn't turn into fibrosis and, as you said, the wall thickening on the bases seems to be a different issue. I can't offer medical advice but, yes, do keep after your doctors to get some answers.

barbojoy

Thank you, @ratherbesailing ! I appreciated the reply & it is comforting to know that for most this goes away on its own. Hopefully, that means with the additional steroids that I'll be in good shape.