Should ‘benign mucus plugging’ prompt pulmonologist visit?

Question: IhadaCT scan in July as part of my follow-up care for grade 1 chondrosarcoma. My scans were good, showing no cancer issues; however, one item that was noted said, “scattered areas of benign mucus plugging.” This was the first time th atpar ticular issue had been noted. My orthopedic oncologist did not mention this at all, and the only reason that Ihavetakennoteofitis because another member of the chondrosarcoma support group I belong to mentioned that she had them noted on her scan, and asked if other people had seen it as well.

I contacted my primary care physician to ask what it means, and she said that the note saying they were benign indicates that there isn’t anything necessarily to worry about, but said she could refer me to a pulmonologist if I would like a referral. I really don’t want to have any additional specialist visits if there is no need, but I still don’t understand what it means. I am a retired 65-year-old woman in good health, and I exercise on a recumbent bike and treadmill almost eve ry day for at least an hour. I have not noticed a nybre athing difficulties while I am exercising. — T.M.H.

Answer: The lining of the lung is protected by cells producing mucus, and cilia (small, hairlike projections on the cells lining the airways) continuously clear the mucus. Occasionally the mucus gets to o thick, and literally can plug a small airway. This can be removed with a forceful cough.

It’s possibl eyou have some distant residual damage from smoking years ago or that you have asth mathatissomild you haven’t noticed it. However, since you are able to exerci sew ithout problems (congratulations on keeping so active), I agree with your primary care doctor that further evaluation probably is unnecessary.

Q: I’m a 63-year-old fem alewho’shavingareal hard time deciphering if the redness and intense heat on my face (normally on my right side) is rosacea or menopause. T hereissome sweating also, but n otalot.I’mon hormones for menopause, but if it’s actually rosacea, then I could come off them. I reall ydon’t have to be doing anything (nowadays) when it just randomly comes on. How do I tell which it is? —

D.H.

A: Rosacea is a chronic skin disorder that is most conspicuous on the face. It can get worse periodically, which might seem similar to menopausal hot flashes (and of course it’s possible to have both). However, rosacea flares usually are triggered by something identifiable: drinking hot liquids, exercise, strong feelings. Hot flashes usually come out of nowhere, and the skin is normal when not flushed.

The skin findings of rosacea are characteristic, present all the time, and most generalists and any dermatologist should be able to make the diagnosis by exam; occasionally, a biopsy is needed.