Silicosis with progressive massive fibrosis

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Progressive shortness of breath.

Patient Data

Age: 40 years
Gender: Male

The CT scan demonstrates:

  • numerous calcified hilar and mediastinal lymphadenopathy "eggshell calcification pattern"
  • large mass-like conglomerates with calcifications and associated radiating strands are noted in the upper zones mainly the dorsal segment of the upper lobes, apical segment of the right lower lobe
  • Multiple well-defined small lung nodules relatively uniform in shape are noted bilaterally predominantly in the upper lobes and apical segment of the lower lobes with nodular thickening of the peribronchovascular interstitium, fissural distortion and emphysematous bullae of the apical segment of the left upper lobe
  • No cavitary lesion is seen

Case Discussion

The CT features of bilateral partially calcified mass-like conglomerates, mediastinal and hilar lymphadenopathy with "eggshell calcification pattern" and bilateral small lung nodules in a patient with a history of exposure to silica particles (18 years as a stone carver in this case) is highly suggestive of silicosis with progressive massive fibrosis (PMF)

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