Progressive massive fibrosis

Case contributed by Abdulaziz Hanash Rajeh
Diagnosis almost certain

Presentation

Chronic cough and weight loss for three years. Occupational history of stone-cutting.

Patient Data

Age: 70 years
Gender: Male

Bilateral nearly symmetrical peri hilar mass-like lung opacification with radiating strands and multiple enlarged hilar lymph nodes, some calcified.

Widespread coarse nodular septal thickening in both lungs. No effusions.

Case Discussion

Bronchoscopy and bronchoalveolar lavage were negative for malignancy and TB.

Progressive massive fibrosis (PMF) refers to the formation of large mass-like conglomerates, predominantly in the upper lobes. These classically develop in the context of certain pneumoconioses (especially coal worker's pneumoconiosis and silicosis) although similar mass-like densities have occasionally been described with talcosis.

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