Silicosis with progressive massive fibrosis
Citation, DOI, disclosures and case data
At the time the case was submitted for publication Frank Gaillard had no recorded disclosures.
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Progressive shortness of breath.
Patient Data
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There is bilateral diffuse upper lobe reticular shadowing superimposed with occasional scattered mass like opacities.
1 case question available
Q: If the symptoms are progressive and there is no acute infection, what important occupational history needs to be elicited ? show answer
A: Occupations such as mining, quarrying, and tunneling
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CT scan shows upper zone predominant mass-like scarring with calcification and volume loss. Hilar and mediastinal lymph node calcification also noted. No cavitary changes are seen. There is a left pleural effusion.
4 case questions available
Q: What is the most likely diagnosis ? show answer
A: Silicosis
Q: Is this simple or complicated silicosis ? show answer
A: Complicated silicosis
Q: Allowing for the absence of cavitatory and tree in bud changes, what would be an important differential diagnosis (as well as a potential complication) to consider? show answer
A: Pulmonary tuberculosis
Q: What incidental finding is present in the upper abdomen ? show answer
A: Pneumobilia
Case Discussion
Chest x-ray and CT scan of the chest demonstrate characteristic upper zone mass-like scarring with calcification and volume loss. Hilar and mediastinal lymph node calcification is also demonstrated. Features are in keeping with silicosis and progressive massive fibrosis (PMF).
References
- 1. Kim KI, Kim CW, Lee MK et-al. Imaging of occupational lung disease. Radiographics. 2001;21 (6): 1371-91. Radiographics (full text) - Pubmed citation
- 2. Chong S, Lee KS, Chung MJ et-al. Pneumoconiosis: comparison of imaging and pathologic findings. Radiographics. 2006;26 (1): 59-77. Radiographics (full text) - doi:10.1148/rg.261055070 - Pubmed citation
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