Increased lung markings is a common image on a chest X-ray or CT scan.

The chest cavity houses several important structures, such as the pulmonary arteries, pulmonary veinstrachea, trachea and bronchi. On imaging, these structures appear as shadows that look like a tree growing upside down. And the term for this is lung markings. When there is an increase in the shadows, it results in increased lung markings.

Causes

There’re a variety of reasons why increased lung markings can occur.

Increased markings may often occur in healthy people. It may simply be due to increased blood flow to the lungs, which can be a normal finding. For example, increased markings may occur in certain groups of people, such as the young, the elderly, the overweight, and pregnant women.

Similarly, after exercise, people’s lungs might become congested, which may also appear as increased markings on imaging.

Long-term smoking can lead to increased markings as well.

Furthermore, some lung diseases can also cause increased markings. Some of the common ones are chronic bronchitis, bronchiectasis, chronic obstructive pulmonary disease (COPD), and interstitial lung disease. These conditions can cause pulmonary stasis or recurrent coughing, leading to congestion and edema of the airway mucosa. This results in increased markings on images.

In addition, some heart conditions, such as left heart failure or precordial disease, can cause pulmonary oedema, which can also lead to increased lung markings.

Treatment

Usually, if there are no symptoms associated, an increase in lung markings does not indicate a health issue. Therefore, there is no need for treatment, except for possible follow-up visits in some cases.

Increased markings is frequently caused by inflammation when there are symptoms, such as coughing and sputum, but may also be due to other conditions. Diagnosing the cause requires a comprehensive evaluation, which may include a medical history, physical examination, laboratory tests, imaging studies, etc. Therefore, seeking medical attention for symptomatic management is recommended in such cases.