“ CWP Due to exposure to coal dust. Increased risk of chronic obstructive pulmonary disease (COPD) and progressive massive fibrosis (PMF). ...
“
CWP
Due to exposure to coal dust. Increased risk of chronic obstructive pulmonary disease (COPD) and progressive massive fibrosis (PMF). Caplan syndrome is CWP with features of rheumatoid arthritis.
• Small, well-defined nodules of 1-5 mm with an upper lobe predominance
• Calcification on chest x-ray in up to 20%
CT
• Diffuse nodules
• Hilar or mediastinal lymph node enlargement with or without central node calcification (eggshell calcification also sometimes present)
Silicosis
Due to exposure to silica (e.g. sandblasting or mining). Acute exposure to large volumes of silica causes acute silicosis (‘silicoproteinosis’)—classic silicosis is a chronic form. Becomes complicated (i.e. PMF) more commonly than CWP.
Plain film
• Small (less than 10 mm) calcified nodules, more commonly in the upper zones.
• Check for bilateral mediastinal or hilar lymph node enlargement.
• PMF occurs where the nodules grow and coalesce, forming large opacities in the upper zones—these are typically sausage shaped with fewer adjacent nodules and eventually migrate towards the hilum.
• Upper lobe fibrosis.
CT
• Hyperdense/calcified nodules.
• Eggshell lymph node calcification is practically pathognomonic of silicosis.
• Acute silicoproteinosis has a similar appearance to pulmonary alveolar proteinosis.
Silicosis. Chest x-ray demonstrating multiple small calcified nodules. In the right mid-zone, nodules coalesce, in keeping with progressive massive fibrosis. There is upper lobe fibrosis with volume loss and ascent of the hila bilaterally.
”
- For Radiology Cases, Discussion join: Radiology Made Easy on Facebook
- Subscribe to our youtube channel for FRCR radiology case discussion
- Join our Telegram group: Radiology Made Easy
