Presentation
Retired coal miner. Long history of chronic breathing problems following medical retirement from the coal face.
Patient Data
Bilateral upper lobe fibrosis.
Bilateral upper lobe masses, more defined in the right upper lobe.
The pit head of Treeton Colliery, Yorkshire, UK. Circa 1970's. A typical coal mine that was commonplace in the 1960-80's across northern England.
Photo courtesy of Ian Bickle personal collection.
Case Discussion
Now near defunct, coal mining previously represented a huge industry employing hundreds of thousands of men in the UK, especially the North of England.
Exposure to inorganic dusts causes a range of medical problems, especially involving the chest, including: pulmonary fibrosis, coal worker's pneumoconiosis and progressive massive fibrosis (PMF).
A good proportion of these workers also smoked, so the initial presentation with a 'mass on chest x-ray' poses a diagnosis conundrum. With serial old films, cases like this one confirmed PMF.