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.
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.