Case contributed by Ian Bickle
Diagnosis almost certain


Elderly male patient who is a regular respiratory clinic attendee and former coal miner.

Patient Data

Age: 80 years
Gender: Male

Volume loss in both upper lobes.

Bilateral apical conglomerate fibrosis.

Diffuse predominently upper lobe nodularity.

Case Discussion

Pneumoconiosis is lung disease secondarily to the exposure to inorganic dusts, in many  developed countries related to now decaying industries such as coal mining.

The prolonged expsoure to these dusts can give rise to lung fibrosis, which on occasion may progress to a conglomerate form mimicking masses in the lungs (PMF).

Nodularity often accompanies the fibrosis.  Many types of coal have silica components, which results in the more specific term of silicosis.

Calcified mediastinal lymph nodes may also be a feature.


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