Pleural parenchymal scarring
Read Your Scan Editorial Team·Last updated
Written from published radiology references and reviewed for plain language. Not written or signed by a physician, and not a diagnosis. How we write these pages →
In plain language
Fibrous tissue where the lung meets its lining, left behind by an old infection or inflammation that has healed. It is usually stable and often noted only for comparison with future scans.
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Where you'll see this
This wording turns up on Chest CT reports — CT imaging of the chest. A chest CT gives a much more detailed view than a regular chest X-ray. It shows the lungs and airways, the space between the lungs (the mediastinum), lymph nodes, blood vessels, the heart’s outline, and the chest wall. Doctors order it to look more closely at a cough, shortness of breath, an abnormal X-ray, a known nodule, an infection, or to check blood vessels. Seeing something on the images does not by itself mean something is wrong — your doctor reads the pictures together with your history and other tests.
Questions worth asking your doctor
- What was the main reason this chest CT was ordered, and did it answer that question?
- Were any findings unexpected, and do any of them need follow-up?
- If a nodule was seen, does it need another scan later, and when?
- Do the results change anything about my current treatment or medications?
- Is there anything in my history that helps explain what the report describes?
How common is this?
This is one of the most frequent incidental findings on a chest CT, and it turns up especially at the top of the lungs, where reports call it apical or biapical scarring. It is fibrous tissue left where the lung meets its lining after an old infection or inflammation healed. Most people who have it never knew about the episode that caused it — a chest infection years ago, sometimes decades, is the usual story.
When should I worry?
Scarring itself is finished business: it is the mark left by something that has already resolved, and it does not turn into anything. The reason it is reported at all is that it needs to be distinguishable from active disease on any future scan, and stability over time is the strongest evidence of that. What prompts further thought is not the scarring but change — an area described as new, growing, or with features that do not fit old fibrosis. A radiologist with any doubt says so explicitly rather than leaving the word scarring to carry it.
What happens next
In the great majority of cases, nothing at all. If you have a previous chest image, the most valuable next step is comparison: an area unchanged for years is settled. Where there is no prior imaging and the appearance is not typical enough to dismiss, a repeat scan after an interval is the usual approach — not because anything is suspected, but because stability is the answer and it takes time to demonstrate.
Frequently asked questions
- What does biapical pleural parenchymal scarring mean?
- Biapical means at the top of both lungs. It is a very common location for old, healed scarring, and the phrase as a whole describes fibrous tissue at the lung surface on both sides. On its own it is an incidental finding rather than a diagnosis.
- Can lung scarring be reversed or treated?
- No, and it does not need to be. Scar tissue is the healed end state of a past inflammation, not an ongoing process. A small area of it has no effect on how the lungs work and there is nothing to treat.
- Does scarring mean I had tuberculosis?
- Not necessarily, though old TB is one recognised cause and the reason apical scarring is looked at carefully in some populations. Ordinary chest infections, pneumonia and previous inflammation account for a great many of these areas. If the question matters in your case, your doctor can address it directly.
Other words on the same report
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