AIRP Best Cases in Radiologic-Pathologic Correlation: Coal Workers’ Pneumoconiosis

Abstract

An 89-year-old male former foundry worker with a history of significant cardiac findings presented to the hospital with recently increased shortness of breath. The patient described the shortness of breath as present at baseline and nonpositional and acknowledged that it had recently progressed in severity. The findings at physical examination included normal oxygen saturation and bilateral rales. The patient was ultimately found to have critical aortic stenosis, and surgery was recommended. During the initial workup prior to surgery, chest radiography was performed. The patient died as a result of complications after reparative surgery was performed during a subsequent admission. Imaging Findings Posteroanterior and lateral chest radiographs disclosed bilateral upper lobe-predominant peripheral reticular opacities (Fig 1). Computed tomography (CT) was recommended for further evaluation.

An Unusual Case of Pulmonary Alveolar Microlithiasis Masquerading as Pulmonary Tuberculosis

“…Calcifications can form in 10%-20% of patients. [10] Histopathological examination of the transbronchial biopsy obtained in our case did not show any of the mentioned features. Histopathological examination in a case of PAM is characterized by presence of microliths or calcospherites within the alveoli.…”

“…In contrast to PAM, HRCT in simple coal workers pneumoconiosis typically reveals small 2-5mm centrilobular and subpleural circumscribed nodules predominantly in upper lobes but can involve the entire lung parenchyma diffusely. [10] On microscopic examination, coal macules around respiratory bronchioles are the characteristic finding of pneumoconiosis comprising of carbon-containing macrophages surrounded by a network of collagen fibers and fibroblasts. Calcifications can form in 10%-20% of patients.…”

Progressive plasterer’s pneumoconiosis complicated by fibrotic interstitial pneumonia: a case report

“…There are no curative therapies for pneumoconiosis and supportive therapy is the best therapeutic option; management is limited to the avoidance of further dust exposure, symptomatic therapy, such as bronchodilators for the treatment of airflow obstruction, and the prevention of infection [19, 20]. In our case, the cessation of plastering provided only a temporary effect, the administration of nintedanib was ineffective, and he currently uses supplemental oxygen.…”