Lung opacities are abnormalities seen on an x-ray or CT scan of the chest. They can have many causes. A cold ? A Covid? Cancer ?
Definition: what is a pulmonary opacity?
“Lung opacity is a radiological term used when we see an anomaly on the x-ray or scanner. The lung is normally filled with air and appears black on an X-ray. When there is opacity, there is a gray or white spot on the x-rayit means that the lung loses its normal transparency” informs Dr Samia Boussouar, radiologist in the Cardiovascular and Thoracic Imaging Department (ICT) – Pitié-Salpêtrière University Hospital Group Hospital, also practicing at the Western Parisian Medical Imaging Center (CIMOP) and member of the Society of Thoracic Imaging (SIT). Whenthere is presence of water (oedema), a nodule, an infectionthe lung loses its normal aeration and opacity may be visible.
What causes lung opacity?
Lung opacity is an abnormal picture of the lung that can have several causes.
► “In an acute context, pulmonary opacity can have infectious causes such as flu, Covid-19, bacterial infection (Pneumococcus for example) or fungal – due to a fungus)“informs Dr. Boussouar. She cites the example of pulmonary opacities due to Covid-19.”During the Covid-19 pandemic, when we couldn’t get the results of a PCR test quickly enough, we did a CT scan and it showed typical Covid opacities“ she explains.
► Outside an infectious contextpulmonary opacity may have tumor causes or more rarely be due to an autoimmune disease. She may also have a cardiac cause (which leads to pulmonary oedema). “Depending on the location, the shape, the extent (focal or very diffuse), certain characteristics evoking certain germs, the number of anomalies present and the context (fever), we evoke a diagnosis “ indicates the radiologist.
What are the symptoms of pulmonary opacity?
Any cloudiness may manifest as respiratory symptoms such as cough, severe shortness of breath (dyspnea), sputum (dirty, bloody) or appear as extra-pulmonary signs which depend on the cause as well as the fever in an infectious context, weight loss in the context of cancer, edema lower limbs in a cardiac cause… The diagnosis can also be fortuitous. “The lung does not hurt, so pulmonary opacity does not result in pain. The only case in which a pulmonary opacity causes pain it is when the opacity is in contact with the pleura (envelope that surrounds the lung), whatever its cause” inform the radiologist. The context of pulmonary opacity is therefore very important.
Is this a sign of cancer?
“Lung cancer always shows up as lung opacity on a CT scan, but may not be visible on an X-ray” informs the radiologist. But any lung opacity is not a sign of lung cancer. “Here again, the context is important. If this pulmonary opacity is observed in a smoker, who has a history of cancer, we fear lung cancer or the presence of pulmonary metastases” says Dr. Samia Boussouar.
Lung opacity is not a disease. A lung opacity is an x-ray image. “This is a term used when a chest x-ray or chest scan is done.” says Dr. Boussouar. It is the translation of a disease (infection, cancer, etc.).
What treatment to treat pulmonary opacity?
Treatment for pulmonary opacity depends on the cause. “This requires investigating this opacity, first of all by a meticulous medical examination which will guide the additional examinations (blood test which gives arguments in favor of an infection for example), sometimes a fibroscopy, with possible puncture and analysis histological” informs Dr. Boussouar. If its cause is a bacterial infection, it is treated with antibiotics. “Lung opacity due to infection or cardiac origin may be a medical emergency“ says the radiologist. If the lung opacity looks cancerous, a balance sheet is required before deciding on treatment.
Thanks to Dr. Samia Boussouar, radiologist in the Cardiovascular and Thoracic Imaging Department (ICT) – Pitié-Salpêtrière University Hospital Hospital Group