Mixed pneumoconiosis - silicosis, coal workers' pneumoconiosis and asbestos-related pleural disease
Presentation
Cough.
Patient Data
Large left apical cavitary lesion with peripheral mural nodule. Pulmonary findings are compatible with complicated silicosis.
Innumerable interstitial pulmonary nodules, calcified mediastinal and hilar lymphadenopathy and architectural distortion with retraction of the hila. Calcific pleural plaques and pleural effusion from prior asbestos exposure. Severe emphysema.
Case Discussion
This is an example of a patient that has been exposed to various types of dust, includes silica, coal particles and asbestos. There is upper lobe fibrocavitary changes, innumerable interstitial pulmonary nodules, calcified mediastinal and hilar lymphadenopathy, and architectural distortion with retraction of the hila. Calcific pleural plaques and pleural effusion from prior asbestos exposure are also present.
Acute silicosis is indistinguishable from alveolar proteinosis. Then evolution into fibrosis and architectural distortion with upper lobe predominance occurs. Coal dust aggregates in the respiratory bronchioles tend to cause less fibrosis compared to silicosis and can lead to emphysema 1.
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