Silicosis - eggshell calcification

Case contributed by Dr Prat Matifoll


Routine pre-operative chest radiograph prior to surgery for urethral stenosis. 50 year smoking history.

Patient Data

Age: 75 years
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 in this case)
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Case information

rID: 32491
Published: 21st Aug 2015
Last edited: 23rd Nov 2019
System: Chest
Inclusion in quiz mode: Included

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