Lung Center

What is Lung Scarring?

Many NetWellness visitors have questions pertaining to lung scars. What exactly is a lung scar, and what does it mean with regard to my health?

Lung Scars

Scars in the lung, like scars on the skin, are permanent and usually cannot be removed. However, the lung is remarkably resilient and able to withstand small scars without any ill effects. Granulomas are scars that are caused by previous infection and can develop into calcified scars. Normally, these lesions are not treated and there is neither treatment nor necessity for their removal. Much like a scar on the skin, stable scars on the lung are generally not treated.

Calcified scars are usually caused by previous lung infections such as pneumonia. In the Ohio River Valley specifically, there is a fungus in the soil known as histoplasmosis that sometimes causes infection but rarely causes any health problems. Tuberculosis infections can also cause granulomas. Other factors that can cause calcified scars over time, include:

Silicosis (from inhalation of silica dust)
Asbestosis (from inhalation of asbestos)
Sarcoidosis
Cystic fibrosis
Prior infections (such as pneumonia, tuberculosis infections, or fungal infections)

In some cases, scar tissue can build up and escalate into issues such as interstitial lung disease and pulmonary fibrosis (where swelling and inflammation occur).

Symptoms and Tests

If you have lung scarring, you should check with your health care provider as soon as possible if you are currently experiencing symptoms of:

Cough
Shortness of breath
Fever
Chills
Night sweats
Weight loss
Decreased energy level

These may be symptoms of a more serious condition.

Dealing with lung scarring begins with identifying the size and stability of the scar. If, for instance, you have an old chest x-ray (CXR) and a new one, a doctor can view if the scar has stabilized or is malignant (spreading). Also, a CXR can show whether the scar tissue is localized (or in one place) or more spread.

If localized and unchanged in size for at least 2 years, it generally indicates a harmless granuloma caused by an old infection like pneumonia.
If it has spread, it can be the result of toxic exposures or primary scarring diseases of the lung, such as asbestos or diseases like idiopathic pulmonary fibrosis.

Because it is sometimes difficult to tell whether scar tissue is benign or cancerous, a CT scan is occasionally required.

Pending the results of such scans, ask your health care provider for the next steps to take and options available for your specific condition.

For more information:

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Last Reviewed: Jul 19, 2010

James N Allen, Jr, MD
Clinical Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University

James Knepler, MD
Formerly, Assistant Professor
College of Medicine
University of Cincinnati

Larry S Schlesinger, MD
Professor:
Molecular Virology, Immunology and Medical Genetics
Microbiology Administration
Environmental Health Sciences
College of Medicine
The Ohio State University

Shu-Hua Wang, MD, MPH&TM
Clinical Assistant Professor of Infectious Diseases
Clinical Assistant Professor of The Division of Epidemiology
College of Medicine
The Ohio State University