What is Parenchymal Scarring?

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  • Written By: Mary McMahon
  • Edited By: Kristen Osborne
  • Last Modified Date: 29 September 2019
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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.


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Post 6

As an incidental finding on a chest x-ray, the report mentioned Minimal

biapical pleuroparenchymal scarring. Should I be concerned?

Post 5

I just had my third pacemaker installed and my x-ray showed apical pleural-parenchymal scarring. I found this information out by accident (the doctor has not mentioned it).

I have had over eight chest x-rays in the past seven years and this has never been mentioned before. I have had five stents placed for blockages that were caught by breathing issues. What could have caused this finding?

Past history: I worked in the carbide grinding industry for 25 years. I retired six years ago and stopped smoking 25 years ago.

Post 4

@kylee07drg - I really doubt that it’s cancerous. I think you have to smoke for many years to have that degree of parenchymal scarring.

My grandfather smoked for over twenty years, and his lungs looked horrible by the time he was sixty. He developed emphysema, which slowly choked out his lung function. Scar tissue replaced healthy tissue, and this took the elasticity right out of his lungs.

Toward the end of his life, he struggled for every breath. You could hear a constant wheezing in his chest, and he wished so strongly that he had never lit up that first cigarette. I wish every young person who smokes could meet an elderly person with emphysema, because I think it would change their minds.

Post 3

My doctor found a spot on my lung a few years ago, but he said it was probably nothing to worry about. He thinks it is just scar tissue from the time I had pneumonia.

My lungs were really irritated at the time. It took me years to really breathe normally again after my battle with pneumonia.

I have to go in for another set of x-rays next week, and I am hoping that I don’t have lung cancer. I only smoked for about six months before quitting for good, and it would be a shame if I had to pay for that with my life.

Post 2

@orangey03 - Why not? Pleural scarring is nothing to take lying down. I think that these companies should be made to pay, whether they knew that they were doing wrong at the time or not.

The fact remains that businesses that used asbestos put all their employees at risk for lung damage. So, should these employees really be left with the large medical bills that they acquire through no fault of their own?

No! Their employers should be the ones responsible. I’m glad that there are so many lawsuits against places that exposed their workers to asbestos. It sets an example for employers in the future.

Post 1

My uncle has parenchymal scarring that was caused by exposure to asbestos. He used to work in a factory that had been constructed with asbestos as the insulation, and he spent nearly thirty years there.

He has had trouble breathing for many years, and it’s only getting worse. The asbestos inflamed his lungs, and that constant inflammation made the scar tissue form.

Though it is very upsetting, he realizes that the company is not to blame. Everyone at that time used asbestos and thought it harmless. He isn’t going to get involved in one of these class action lawsuits.

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