Silicosis: eggshell calcification

Case contributed by Dr Prat-Matifoll

Presentation

50 years smoker. He required a chest plain film previous to undergo surgery (urethral stenosis).

Patient Data

Age: 74
Gender: Male
X-ray

Frontal:

Ill-defined bilateral hila with multiple calcified adenopathies in it and in the retrocardiac space. Right costophrenic angle blunting. Aortic arch elongated and calcified.

Lateral:

We can easily appreciate the "eggshell" calcification of multiple adenopathies along the mediastinum and bilateral pulmonary hila.

Case Discussion

Main causes of lymph node calcification:

  • benign
    • tuberculosis
    • histoplasmosis
    • sarcoidosis
    • silicosis
    • coal worker's pneumoconiosis
    • amyloidosis
  • malignant
    • ​treated lymphoma and metastases

Aids to differentiating cause: silicosis vs sarcoidosis vs tuberculosis

  • calcified lymph nodes in tuberculosis tend to affect the mediastinum asymmetrically and unilaterally
  • diffuse bilateral lymph node involvement is more common in sarcoidosis
  • silicosis: the patient usually has a history of a silica-exposure related job (as it was in this case)
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Case information

rID: 32491
Case created: 28th Nov 2014
Last edited: 9th May 2017
System: Chest
Inclusion in quiz mode: Included

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