Biapical pleural parenchymal scarring, a specific form of lung tissue damage located at both lung apices, can be a silent marker of past pulmonary conditions. Such scarring is often detected incidentally during imaging for other reasons.
While the exact prevalence is not well-documented, the presence of these scars can be indicative of previous infections, inflammation, or exposure to harmful substances. A healthcare professional can assess the significance of this finding, considering that scarring can impact lung function to varying degrees. By evaluating medical images and patient history, doctors devise personalized management plans to address any associated health concerns.
Surgeries, infections, chronic lung disease, exposure to harmful particulates, and cancers are all potential causes of parenchymal scarring. The scarring occurs as a result of irritation or damage to the tissues, with the tissue scarring over during the healing process. Scars can be fibrous and tough, and extensive scarring may interfere with a patient's lung function, making it harder to breathe or reducing availability of oxygen to the patient. In other cases, the scarring may be benign, and will not cause any problems for the patient.
On X-rays, changes to the lung tissue can be visible. If scarring is identified, a doctor may request more medical imaging to see how extensive it is and learn more about it. In some cases, a request for biopsy will be made. In a biopsy, a sample of the scar tissue will be taken from the lung and analyzed by a pathologist to learn more about its nature and origins. This can provide important information a doctor will use in developing a treatment plan to manage the scarring.
If the parenchymal scarring is not benign, treatment can include steps to reduce further damage, such as changing a medication regimen for lung disease to bring inflammation down. In some cases, part of the lung may be removed, as for example if a patient has lung cancer. Lung transplants may be needed in some cases, if it is clear that the damage to the lungs is too extensive to repair. While awaiting transplant, patients may be provided with various treatments to keep them stable and comfortable.
There are some steps people can take to prevent parenchymal scarring or reduce its severity. Prompt treatment for problems involving the lungs is advised, as is ongoing monitoring of people with lung disease. Catching complications or poor responses to medications quickly will allow doctors to provide patients with treatments, and these can limit the chances of permanent damage to the lungs. Even with prompt intervention and management, however, some patients may develop scarring anyway.
Is Parenchymal Scarring Serious?
The scarring of small areas of lung tissue by itself isn’t necessarily serious. The presence of Parenchymal scarring will not shorten your life expectancy nor affect the quality of your life in any way. However, in cases of widespread and expanding scarring of the lung tissue, this may indicate other health problems.
If lung scarring begins to spread and worsen, your doctor will determine what is causing this and devise a game plan.
When Parenchymal scarring becomes too widespread, your doctor may determine that a lung transplant is necessary. Directly removing the scarring is not an option.
Is a Lung Transplant Necessary?
Most cases of Parenchymal scarring are mild and won’t require treatment. The majority of scars don’t grow or cause any pain to the patient. If there are any symptoms, they are usually mild and are treated with medication or breathing and exercise techniques.
A lung transplant may be the only option in more severe lung scarring cases, such as those diagnosed with pulmonary fibrosis. While these transplants are relatively safe, there are some risks involved. They include:
- The recipient’s body rejects the donor organ
- Airway Blockage
- Pulmonary Edema (fluid in the lung)
- Blood clots
- Infection
What Are The Symptoms of Parenchymal Scarring?
In most cases, patients with mild scarring in small areas will not have any symptoms. If more extensive scarring develops, such as the kind found in lung fibrosis, some common symptoms will arise. They include:
- Sudden weight loss
- Dry cough
- Sore joints and muscles
- Shortness of breath
- Fatigue
- Difficulty breathing during exercise
How Do I Manage Symptoms of Parenchymal Scarring?
When Parenchymal scarring is severe enough to cause symptoms, your doctor may recommend a few different treatment options.
Medication
If scarring spreads, your doctor may describe medication designed to slow scar formation. Such medication includes nintedanib and pirfenidone.
Oxygen Therapy
This option will not treat the damage to the lungs. However, if the scarring has become so abundant that it affects your breathing, oxygen therapy will make breathing easier and reduce any complications from having low blood oxygen levels.
Pulmonary Rehabilitation
This treatment is meant to improve your overall health and help you manage any other symptoms of Parenchymal scarring. Activities might include exercise, breathing techniques, and counseling.
Can I Prevent Parenchymal Scarring From Spreading?
Once you have been diagnosed with Parenchymal scarring, you can take steps to prevent it from spreading further. The earlier you can be diagnosed, the better your chance of preventing spread. Some of the ways you can do this are by:
- Avoiding harmful chemicals such as asbestos and silica
- Quit smoking and avoid secondhand smoke
- Taking prescribed medication as given by your doctor
- Listen to your doctor and stick to your disease management plan
What Are The Possible Complications From Parenchymal Scarring?
Parenchymal scarring in small areas will not affect your daily life. However, widespread scarring can be life-threatening and lead to several complications. These complications include but are not limited to the following:
- Blood clots
- Respiratory failure
- High blood pressure
- Heart failure
- Lung infection
- Lung collapse
- Death
When Should I See My Doctor If I Am Concerned About Possible Parenchymal Scarring?
Parenchymal scarring mainly occurs in small areas of the lungs and is primarily benign. But if they begin to spread, they can cause more severe problems. So if you start to notice symptoms such as chills, fatigue, sudden weight loss, or difficulty breathing, you should consult your doctor at once.
Who Is At Higher Risk of Developing Parenchymal Scarring?
Anyone who works with and around toxins and pollutants will be more susceptible to contracting Parenchymal scarring.
Although there are more restrictions in the workplace to protect workers, the following toxins and pollutants have been known to cause lung damage:
- Asbestos
- Silica dust
- Coal
- Grain dust
- Hard metal dust
- Animal droppings
Also, patients who have been treated for cancer using radiation and other chemotherapy drugs are at risk for lung scarring.
Outside factors, such as age, sex, occupation, and genetic factors, may increase your chances of developing Parenchymal scarring.
Another at-risk group is smokers. Smoking has been linked to most lung-related issues and especially Parenchymal scarring.