Mixed pneumoconiosis - silicosis with PMF and asbestosis
Miner with progressive breathlessness
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Mutiple small calcified nodules in the upper zones of both lungs associated with "egg-shell" calcification of mediastinal nodes and a focus of progressive massive fibrosis (not so massive) in the left upper zone posteriorly. These findings are all features of silicosis. At the bases there are typical features of asbestos exposure including diaphragmatic pleural calcification but no effusion or other features of mesothelioma.