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Progressive massive fibrosis

Case contributed by Benjamin Edwards
Diagnosis almost certain

Presentation

Increasing SOB. History of heavy metal exposure. Non-smoker.

Patient Data

Age: 75 years
Gender: Male
x-ray

Innumerable small nodules coalescing to form rounded masses in the upper zones with associated volume loss and elevation both hilum.

Multiple small soft tissue and calcified pulmonary nodules with an upper lobe predominance coalescing to form partially calcified complex masses with associated volume loss.  Mediastinal and bilateral hilar lymphadenopathy with coarse calcification. 

Case Discussion

Appropriate exposure history is vital to making a diagnosis of pneumoconioses. 

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