Silicosis: eggshell calcification

Case contributed by Dr Prat-Matifoll


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

Patient Data

Age: 74
Gender: Male


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


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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