The use of computerized tomography (CT) scanning has opened up a whole new perspective and considerations on findings that previously were thought to be unimportant, or a least inconsequential. For many years pulmonary physicians had observed that patients with COPD often had findings in their lung tissue similar to patients with so-called “interstitial fibrosis”. Idiopathic interstitial fibrosis is the most common scarring disease of the lung tissue. The findings on CT scanning are sometimes non-specific or even associated with other diseases. Pulmonary physicians are now rethinking the importance of the interstitial scarring (fibrosis) we often see in patients with COPD.

More scans are being done these days for a variety of reasons, not the least of which is that a CT scan of the chest is much more revealing when it comes to the architecture of the chest wall, lung tissue, airways, and even the heart. It is the screening tool of choice as we look for evidence of tumors in patients at high risk for malignancy, but CT scanning also has shown us abnormalities which we had rarely noticed with routine chest x-rays. We are now studying the relationship of these findings to other disease states. This is the case with the finding of interstitial scarring in patients with COPD. It appears that COPD patients with interstitial lung abnormalities have a higher incidence of exacerbations of their disease, along with a more progressive and rapid deterioration in overall lung function. Treatment options are being considered.