Presentation
Shortness of breath.
Patient Data
There is bilateral perihilar large focal opacities with calcifications, along with reticulonodular interstitial pattern, predominantly in the upper lobes. Numerous lymph node eggshell calcifications are present.
There are bilateral perihilar large focal opacities with calcifications, along with reticulonodular interstitial pattern. Groundglass opacities predominantly in the bilateral lower lobes with small bilateral pleural effusions. There is parenchymal scarring and minimal peripheral honeycombing in the lower lobes, consistent with fibrosis. Pleural thickening and volume loss is evident. Numerous lymph node eggshell calcifications within the mediastinum, hila, and abdomen.
Heart is slightly enlarged with a trace-size pericardial effusion. There is prominence of the main pulmonary artery.
Numerous small coarse calcifications within the spleen, consistent with granulomatous disease.
Old thoracic compression fractures as seen on prior studies.
Case Discussion
Patient has an occupational history of sandblasting. He has a known history of fibrotic pneumoconiosis secondary to silicosis, but presented with acute findings of congestive heart failure and pulmonary alveolar edema as visualized on the CT.