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What Is Parenchymal Scarring?

Mary McMahon
Mary McMahon
Mary McMahon
Mary McMahon

Parenchymal scarring is scarring of the tissue in the lungs. It can be caused by a number of things and may be referred to with additional terms to provide information about its location or nature; apical parenchymal scarring, for example, is scarring at the tip of the lung. This change to the lung tissue can be identified on medical imaging studies and while a patient is in surgery. A doctor can determine if it is a cause for concern and make recommendations about the next steps to take in treatment and management of the issue.

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.

Scarring of the tissue of the lungs is referred to as parenchymal scarring.
Scarring of the tissue of the lungs is referred to as parenchymal scarring.

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.

Exposure to harmful chemicals may cause parenchymal scarring.
Exposure to harmful chemicals may cause parenchymal 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.

A biopsy may be conducted of lung scar tissue in order for doctors to learn more about its nature and origins.
A biopsy may be conducted of lung scar tissue in order for doctors to learn more about its nature and origins.

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?

Individuals with severe parenchymal scarring may require a lung transplant.
Individuals with severe parenchymal scarring may require a lung transplant.

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?

Doctors use X-rays and other imaging technology to evaluate the extent of damage from scarring of lung tissue.
Doctors use X-rays and other imaging technology to evaluate the extent of damage from scarring of lung tissue.

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.

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a TheHealthBoard researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a TheHealthBoard researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

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Discussion Comments

anon1001821

As an incidental finding on a chest x-ray, the report mentioned Minimal

biapical pleuroparenchymal scarring. Should I be concerned?

mannaman

I just had my third pacemaker installed and my x-ray showed apical pleural-parenchymal scarring. I found this information out by accident (the doctor has not mentioned it).

I have had over eight chest x-rays in the past seven years and this has never been mentioned before. I have had five stents placed for blockages that were caught by breathing issues. What could have caused this finding?

Past history: I worked in the carbide grinding industry for 25 years. I retired six years ago and stopped smoking 25 years ago.

cloudel

@kylee07drg - I really doubt that it’s cancerous. I think you have to smoke for many years to have that degree of parenchymal scarring.

My grandfather smoked for over twenty years, and his lungs looked horrible by the time he was sixty. He developed emphysema, which slowly choked out his lung function. Scar tissue replaced healthy tissue, and this took the elasticity right out of his lungs.

Toward the end of his life, he struggled for every breath. You could hear a constant wheezing in his chest, and he wished so strongly that he had never lit up that first cigarette. I wish every young person who smokes could meet an elderly person with emphysema, because I think it would change their minds.

kylee07drg

My doctor found a spot on my lung a few years ago, but he said it was probably nothing to worry about. He thinks it is just scar tissue from the time I had pneumonia.

My lungs were really irritated at the time. It took me years to really breathe normally again after my battle with pneumonia.

I have to go in for another set of x-rays next week, and I am hoping that I don’t have lung cancer. I only smoked for about six months before quitting for good, and it would be a shame if I had to pay for that with my life.

OeKc05

@orangey03 - Why not? Pleural scarring is nothing to take lying down. I think that these companies should be made to pay, whether they knew that they were doing wrong at the time or not.

The fact remains that businesses that used asbestos put all their employees at risk for lung damage. So, should these employees really be left with the large medical bills that they acquire through no fault of their own?

No! Their employers should be the ones responsible. I’m glad that there are so many lawsuits against places that exposed their workers to asbestos. It sets an example for employers in the future.

orangey03

My uncle has parenchymal scarring that was caused by exposure to asbestos. He used to work in a factory that had been constructed with asbestos as the insulation, and he spent nearly thirty years there.

He has had trouble breathing for many years, and it’s only getting worse. The asbestos inflamed his lungs, and that constant inflammation made the scar tissue form.

Though it is very upsetting, he realizes that the company is not to blame. Everyone at that time used asbestos and thought it harmless. He isn’t going to get involved in one of these class action lawsuits.

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    • Scarring of the tissue of the lungs is referred to as parenchymal scarring.
      By: Naeblys
      Scarring of the tissue of the lungs is referred to as parenchymal scarring.
    • Exposure to harmful chemicals may cause parenchymal scarring.
      By: endostock
      Exposure to harmful chemicals may cause parenchymal scarring.
    • A biopsy may be conducted of lung scar tissue in order for doctors to learn more about its nature and origins.
      By: nandyphotos
      A biopsy may be conducted of lung scar tissue in order for doctors to learn more about its nature and origins.
    • Individuals with severe parenchymal scarring may require a lung transplant.
      By: RioPatuca Images
      Individuals with severe parenchymal scarring may require a lung transplant.
    • Doctors use X-rays and other imaging technology to evaluate the extent of damage from scarring of lung tissue.
      By: citylights
      Doctors use X-rays and other imaging technology to evaluate the extent of damage from scarring of lung tissue.