Diagnostic Utility of HRCT Chest in Detecting Pulmonary Pathologies Among Symptomatic Smokers
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Background: Chronic tobacco smoking is associated with multiple pulmonary abnormalities, including emphysema, respiratory bronchiolitis, pulmonary tuberculosis, lung nodules, pneumothorax, and interstitial lung disease. Early structural abnormalities may be difficult to characterize using routine clinical assessment alone, particularly in symptomatic smokers with chronic cough, sputum production, dyspnoea, or haemoptysis. Objective: To determine the frequency and anatomical distribution of HRCT-detected pulmonary abnormalities among symptomatic adult smokers. Methods: This prospective observational imaging study was conducted at Lahore General Hospital over 90 days and included 93 adult current smokers with respiratory symptoms and a cumulative exposure of at least 10 pack-years. Clinical symptoms, smoking exposure, family history, HRCT-detected pulmonary abnormalities, and lung-zone involvement were recorded using a structured data collection approach. Data were analyzed descriptively using SPSS version 27. Results: The mean age was 52.72 ± 13.40 years, mean smoking duration was 23.32 ± 10.60 years, and mean pack-year exposure was 18.14 ± 7.03. Cough was reported by 74 participants (79.6%), sputum production by 70 (75.3%), dyspnoea by 69 (74.2%), and haemoptysis by 20 (21.5%). HRCT showed emphysema in 59 participants (63.4%), pulmonary tuberculosis-related radiological abnormalities in 30 (32.3%), respiratory bronchiolitis in 15 (16.1%), pneumothorax in 2 (2.2%), and lung nodules in 2 (2.2%). Middle-zone involvement was most frequent, occurring in 29 participants (31.2%). Conclusion: HRCT identified a substantial burden of pulmonary abnormalities among symptomatic smokers, particularly emphysema, tuberculosis-related radiological abnormalities, and respiratory bronchiolitis. These findings support HRCT as a useful anatomical imaging modality in clinically selected symptomatic smokers, while formal diagnostic accuracy requires comparison with an independent reference standard
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