Silicosis with progressive massive fibrosis

Case contributed by Dr Yair Glick

Presentation

Hospitalised for intermittent fever. History of severe silicosis, lung transplant candidate.

Patient Data

Age: 50 years
Gender: Male

Severe apical fibrosis and diffuse reticulonodular pattern in both lungs.

  • Mild supraclavicular lymphadenopathy (upper edge of scan).
  • Non-enlarged elliptical axillary lymph nodes with no fatty hila.
  • Mediastinal lymphadenopathy in many stations, with subcarinal nodes reaching 17 mm (short axis).
  • Bilateral hilar lymphadenopathy with delicate peripheral nodules of calcification ("eggshell calcification").
  • Severe bilateral pulmonary fibrosis, particularly in the upper lobes. Innumerable centrilobular nodules diffusely dispersed throughout the lungs.
  • Bilateral postero-medial pleural thickening.
  • Supradiaphragmatic lymphadenopathy, with nodes measuring up to 17 mm (short axis).
  • Gastrohepatic ligament lymphadenopathy, with the largest mass/conglomerate measuring 39 mm across.
  • Hypodense lesion in posteromedial aspect of the spleen measuring 30 x 23 x 30 cm, unchanged compared to previous scan (not shown) - probably a haemangioma.
  • The coeliac trunk is severely stenotic at its origin.
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Case information

rID: 55645
Case created: 19th Sep 2017
Last edited: 6th Oct 2017
System: Chest
Inclusion in quiz mode: Included
Institution: Hillel Yaffe Medical Center

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