Are streaky opacities in chest X-ray associated with malignancy?

Hi,

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I have read through your query in detail. Please find my observations below.

Streaky opacities scattered in both lung fields means that there might be small straight lung shadows along the air passages on your X-ray on both the sides. These prominent airways in the lungs are seen in both lungs and might be due to some sort of inflammation in the airways or possibly due to changes as a result of any lung infection which you had months to years back. This is not indicative of malignancy but with a history of smoking for 20 years and recent onset breathlessness, it requires detailed evaluation.

However, you need to get lung function tests (spirometry) done to know if your lung breathing volume and capacity are within normal limits. Spirometry will also show any reduced breathing capacity that you might have developed due to smoking for 20 years. Your symptoms of shortness of breath might be either due to reduced breathing capacity and exchange of gases in the lungs or due to a heart-related problem. In conclusion, I recommend that you get the lung function tests and an echocardiography is done to confirm that the functioning of lung and heart are within normal range. You can take medicines as given by your doctor and get the X-ray chest repeated after 15 days. If the streaky opacities persist then doing a CT scan chest might be required to study the air passages in detail.