Silicosis, progressive massive fibrosis, and putty kidney

Case contributed by Dr Michael P Hartung

Presentation

Shortness of breath.

Patient Data

Age: 60 years
Gender: Male

Partially calcified mediastinal and hilar adenopathy. 

Left pleural thickening with calcifications. 

Numerous small calcified and non calcified nodules. 

Right apical consolidation.

Right middle lobe bronchus is occluded centrally. The right middle lobe is collapsed with rounded configuration and calcified nodules. 

Areas of scarring, atelectasis, volume loss, and consolidation in the left perihilar region and areas of pleural thickening. 

Partially imaged right kidney with loss of cortex and lobular calcifications in the renal bed conforming to the shape of the kidney. 

Mild upper abdominal periaortic adenopathy. 

Case Discussion

Pulmonary disease likely reflects occupational exposure (mining) in and older male. There may be a combination of silicosis and asbestosis given the pleural disease. There are several coalescing areas of consolidation and fibrosis measuring greater than 1 cm, consistent with progressive massive fibrosis. 

End stage tuberculous infection of the right kidney is partially imaged. The cortex is atrophic, and the kidney is filled with partially calcified caseous necrosis from tuberculous infection. This patient is at increased risk of mycobacterial infection due to the underlying lung disease. 

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Case information

rID: 69369
Published: 8th Jul 2019
Last edited: 8th Jul 2019
System: Chest
Inclusion in quiz mode: Included
Institution: Diospi-Suyana Hospital

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