Interstitial lung pattern on chest X-ray is a common finding in radiology reports which can have numerous causes. This finding can be asymptomatic or have severe and life threatening symptoms. Interstitial pattern on chest X-ray can be in one spot or throughout the lungs.
What is an interstitial lung pattern?
This finding means that there is abnormality of the support tissues of the lung. This is the lung tissue between the spaces that are filled with air in the lung. This says nothing of the cause or diagnosis.
It can be difficult to confidently say on chest X-ray whether the finding on X-ray is truly isolated to the interstitial space of the lung, the air spaces of the lung or both.
What does an interstitial lung pattern look like on a chest x-ray?
On x ray, this will appear to be a lung that has more white markings then the normal lung. This can be in one area or throughout both lungs.
What are the symptoms of an interstitial lung pattern?
The interstitial lung pattern can be without symptoms or associated with severe breathlessness. It depends on the cause. It also depends if the interstitial pattern is new or old. We can tell this from old X-rays you may have had.
What causes an interstitial lung pattern?
The appearance of the interstitial pattern is the same for many diagnosis. Often, the clinical presentation and any prior imaging tests helps us determine the cause.
For example, if you present with breathlessness and have a fever, then infection becomes most likely.
If you have breathlessness and heart problems, then fluid in the lungs becomes a leading cause.
If you recently started a medication, a drug reaction becomes a possibility.
This finding can also be chronic or even asymptomatic. Scarring throughout the lungs from prior infections is a common cause.
Some inflammatory conditions which involve the lung such as sarcoidosis, collagen vascular disorders, and rheumatoid can give this appearance.
Lung disease related to breathing in particles such as asbestos is another cause.
If you have cancer, then spread to the lung of the cancer can cause a condition called lymphangitic carcinomatosis.
If you worked as a shipyard worker or in construction, then asbestos exposure becomes a concern.
The more information the better.
Can we tell the cause from an X-ray alone?
There will sometimes be clues to the diagnosis on the X-ray. For example, if there is a cancerous mass in the lung and interstitial pattern, then lymphangitic carcinomatosis becomes more likely.
If you present with an enlarged heart and interstitial pattern in both lungs then heart failure becomes more likely.
Can an interstitial lung pattern mean lung cancer?
An interstitial pattern in one spot of the lung can be many things with cancer being one possibility.
An interstitial pattern in someone with known cancer can represent spread of the cancer.
Can further image tests helps sort out the possibilities?
CT of the chest can help in some cases. CT will provide more detail and in some cases give us more clues to the underlying condition causing the interstitial pattern.
Interstitial lung pattern treatment
Treatment will depend on the underlying cause. For example, infections may be treated with antibiotics while edema or fluid in the lungs can be treated with diuretics.
Interstitial lung pattern on chest x-ray: summary
Interstitial lung pattern on chest X-ray can have many causes. Arriving at the correct diagnosis can involve a combination of clinical history, additional findings on chest X-ray and further imaging with CT. The treatment will be directed to the underlying cause.