You’ve recently had a chest X-ray and your doctor noted you have lung consolidation. This medical term refers to a collection of fluid or a substance blocking your airways. On a chest X-ray, consolidation looks like solid tissue instead of an open airway. Although lung cancer can cause consolidation, it may also be a sign of an infection or fluid buildup.

In this article, we’ll discuss what lung consolidation is and how it’s diagnosed. We’ll also cover four causes outside of lung cancer that lead to this condition. If you’d like to learn more about lung consolidation and your risk, talk to your doctor.

What Is Lung Consolidation?

Lung consolidation is a term used by doctors to describe lung tissue on an imaging scan. People with consolidation have a dense substance blocking the small airways in their lungs. This blockage also affects the alveoli (tiny air sacs) at the ends of the airways. Your lungs exchange oxygen and carbon dioxide in the alveoli. When they become blocked, you may experience chest pain, shortness of breath, and coughing.

While living with lung cancer, you may have heard of the term “consolidation therapy.” It’s important to note that this is different from lung consolidation. Your doctor may give consolidation therapy, which refers to a follow-up treatment after radiation therapy to treat your lung cancer. In this article, we’re discussing a physical condition affecting the lungs.

Diagnosing Lung Consolidation

Most of the time, lung consolidation is found during a chest X-ray. Your doctor may notice “airspace shadowing.” This term refers to dense white or opaque (not see-through) areas on the X-ray. You’ll need additional tests to find the underlying cause if they find consolidation. Chest X-rays can’t confirm exactly what substance is blocking your airways.

Computed Tomography

Computed tomography (CT) scans create three-dimensional images of your body. The CT scanner takes X-rays at several angles, and a computer program processes the pictures. This makes detailed images that help your doctor better visualize your lungs. They can find exactly where the lung consolidation is located. A lung consolidation may look white and hazy on the CT scan — known as a “ground-glass opacity.” The areas on a lung scan look fuzzy or cloudy, like frosted glass.

Bronchoscopy

A bronchoscopy uses a long, thin tube — known as a “bronchoscope” — to look into your lungs. Your doctor may order a bronchoscopy to take a biopsy or sample from your airways. The sample is then sent to a lab for analysis. This tells your doctor if your lung consolidation is caused by cancer, an infection, or fluid buildup.

Blood Tests

If your doctors think you may have an infection, they’ll likely order a blood test to measure your white blood cell (WBC) levels. WBCs are immune cells that help fight off invading bacteria and viruses. A high WBC count may be a sign that your lung consolidation is caused by an infection.

Sputum Culture

Often referred to as “phlegm,“ sputum is a thick mucus made by your lungs. If your X-rays show lung consolidation, a sputum culture can help determine the cause. Your doctor will collect a sputum sample and test it for bacteria. If you test positive, you have a lung infection causing consolidation.

What Causes Lung Consolidation?

Lung consolidation can develop from several conditions that block the airways. Although lung cancer is the main cause, consolidation can also occur from infections, bleeding, and fluid buildup.

1. Infections

Pus from lung infections can also create lung consolidation that can be seen in chest X-rays. When you’re sick, your immune system sends WBCs to fight the infection. If you have an infection like pneumonia, WBCs can collect in your lungs. This process creates pus, a thick white substance that replaces air in the airways.

Some people with pneumonia can develop lobar consolidation (consolidation of an entire lung lobe). For reference, the right lung has three lobes and the left lung has two. Lobar consolidation develops when bacteria spread inside the lobe between the alveoli. On a chest X-ray, the entire lung lobe will appear white and opaque.

Although a chest X-ray or CT scan can find lung consolidation, you’ll need additional testing to confirm you have an infection. Your doctor will likely order a sputum culture and/or blood tests to make a diagnosis.

2. Cancer

Lung tumors that block the airways can cause lung consolidation. Consolidations can be seen in people with non-small cell lung cancer (NSCLC). This is because adenocarcinoma develops in the epithelial cells that line the airways. Epithelial cells make mucus, a thick, sticky substance that traps and clears out irritants like dust, pollen, smoke, and chemicals.

3. Pulmonary Hemorrhage

“Pulmonary hemorrhage” is the medical term for blood leaking outside the alveoli into the lungs. Doctors typically divide pulmonary hemorrhage into two types — localized and diffuse. Localized hemorrhaging is limited to one area of the lungs and may be caused by:

• Injuries to the chest, such as being in a car accident
• Bacterial infections like tuberculosis or pneumonia
• Malformations in the lung tissue
• Lung tumors

Diffuse hemorrhaging occurs in several areas of the lungs. It typically develops due to an inflammatory disease like lupus. However, diffuse bleeding may also indicate pulmonary hypertension (high blood pressure in the lungs).

Your doctor may see hazy lung consolidation or ground-glass opacities on a chest X-ray or CT scan. They may also order a bronchoscopy to look for any signs of bleeding.

4. Pulmonary Edema

“Pulmonary edema” refers to fluid buildup within the lungs. People with heart disease are more likely to develop this type of edema, but it can also develop from:

• Lung infections or injuries
• Stroke or heart attack
• Kidney problems, as the kidneys control your body’s fluid balance
• Traveling to a higher altitude

People who have also nearly drowned and inhaled water can develop lung consolidation.

If your doctor thinks you may have pulmonary edema, they can order imaging studies to look for consolidation. Other tests include bloodwork to check hormone levels and pulse oximetry to measure oxygen concentrations in your blood.

5. Aspiration

Lung consolidation also occurs when substances accidentally enter the lungs. “Aspiration” refers to breathing food, drink, or stomach contents into the airways. You may have done this before if you accidentally swallowed something “down the wrong pipe.” If you can’t cough the food or water back up, it becomes stuck in the lungs.

Aspiration becomes dangerous if it leads to an infection. You may be at risk of developing aspiration pneumonia, which can also cause lung consolidation. This is because your saliva and food contain bacteria that grow in the lung tissue.

Be sure to let your doctor know if you have trouble swallowing or if you accidentally breathe in food or drinks during mealtimes. They can refer you to a specialist who tests for and treats swallowing problems.

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