Progressive massive fibrosis
Elderly gentleman. Chronic chest disease. Ex coal miner.
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Single lead pacemaker.
Extensive bilateral upper lobe fibrosis with both hila pulled up.
Conglomerate mass like appearances in both upper lobes, more pronounced on the left.
Pneumoconiosis (occupational lung disease) due to the patient's former work in mining with exposure to coal dust.
In addition to the upper lobe fibrosis, this has now turned into conglomerate masses, consistent with progress massive fibrosis.