The clinical pathological analysis of 14 autopsy cases of pneumoconiosis / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the histopathological features, complications, diagnosis, and differential diagnosis of coal workers' pneumoconiosis (CWP).</p><p><b>METHODS</b>The lung tissue sections from 14 autopsy cases of CWP were subjected to HE staining and observed under a light microscope, and a retrospective analysis was performed considering the occupational history and clinical features.</p><p><b>RESULTS</b>The 14 cases were 46-71 years of age (mean, 57.7 years). Two cases were diagnosed as dust reaction, 1 case as simple CWP (stage I anthracosilicosis), and 11 cases as complicated CWP (9 cases of stage II anthracosilicosis, 1 case of stage III anthracosilicosis, and 1 case of stage III silicosis). Twelve cases were complicated by chronic bronchitis and emphysema, 8 cases by pulmonary heart disease, 4 cases by pulmonary tuberculosis, 3 cases by liver cirrhosis and liver cancer with pulmonary metastases, and 2 cases by cerebral hemorrhage.</p><p><b>CONCLUSION</b>Among patients with CWP, the pathological changes of lung tissue become more complex with increasing years of dust exposure. Coal macule is the common pathological feature of CWP, and dust nodules and massive fibrosis are the necessary indices of pathological diagnosis.</p>

Diagnostic value and clinical application of CT/HRCT for coal workers' pneumoconiosis with large opacities / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To study the diagnostic value of CT/HRCT for the coal workers' pneumoconiosis (CWP) with large opacities.</p><p><b>METHODS</b>Sixty-two patients with CWP were examined with both chest radiograph and CT/HRCT scan. Comparison was done.</p><p><b>RESULTS</b>Large opacities were found in 19 patients in the chest radiograph of 62 patients with CWP. The detection rate was 30.6%. Thirty large opacities were found using chest radiograph. Forty-three patients with large opacities were found using the CT/HRCT. The detection rate was 69.4%. One hundred and twenty-three large opacities were found using CT/HRCT. Ninety-three more large opacities were found by CT/HRCT than by chest radiograph. The total detection rate of large opacities by CT was 4.1 times than by chest radiograph. Both differences were statistically significant (chi2 = 18.58, P < 0.01). CT/HRCT found all patients with large opacities detected in the chest radiograph. Seventeen patients with Stage III large opacities (>or= 1.0 cm x 2.0 cm) were found by the chest radiograph. The detection rate was 27.4% (17/62). Twenty-seven large opacities were found using chest radiograph. Thirty-four patients with Stage III large opacities were found using the CT/HRCT. The detection rate was 54.8%. The found Stage III large opacities added up to 67. The found Stage III large opacities by CT/HRCT were 40 more than using chest radiograph. Both differences were statistically significant (chi2 = 9.63, P < 0.01). CT/HRCT was reliable to show the morphology, the inside structure, the tiny lesion and the special location of the large opacities of CWP. It could provide more important information for differential diagnosis.</p><p><b>CONCLUSION</b>CT/HRCT is significantly better than the chest radiograph in the diagnosis of complicated CWP. It can find the large opacities that the chest radiograph can not. It has a great diagnostic and practical value as an assistant examination method. CT/HRCT could be considered as the reference and evidence for staging progression in diagnosis of pneumoconiosis.</p>

The diagnostic value and morphologic manifestation of high resolution computerized tomography in coal miner's pneumoconiosis with pleural pathological changes / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To analyse CT and high resolution computerized tomography (HRCT) diagnostic value and morphologic manifestation in coal miner's pneumoconiosis with pleural pathological changes.</p><p><b>METHODS</b>One hundred and thirty-one cases of coal miner patients with pneumoconiosis (0(+) type: 14 cases, type I: 46 cases, type II: 58 cases, type III: 13 cases) and 20 normal people as control group were first examined by routine CT scan at 4 fixed slices, followed by HRCT examination at the region of interest (ROI). Meanwhile, all of them had high-kV chest radiography.</p><p><b>RESULTS</b>According to the national standard of the People's Republic of China in the diagnosis of coal miner's pneumoconiosis with pleural plaque, 68 cases of pleural disease making up 51.91% (68/131) were found (type I accounted for 17.65%, type II 63.24%, type III 19.12%). The morphologic manifestation of pleural pathology by HRCT could be classified into four types: (1) nodular type: 73.38%, (2) flat type: 18.71%, (3) irregular type: 7.91%, (4) mixed type. The pleural pathological changes were found in thoracic wall pleura (65.02%), surface of mediastinum (22.16%), and pericardium (12.80%), but not found in the top of lung and costo-phrenic angles. The thickness of pleura was often about 5 approximately 10 mm (88.17%).</p><p><b>CONCLUSION</b>Pleural pathological changes were not seldom seen in coal miner's pneumoconiosis. HRCT is a reliable examination method aiding routine CT to show pleural pathological changes, thus it has a great diagnostic and practical value. It is necessary to make a further comparison study between pathology and imagology.</p>

Application of T grain technique to the diagnosis of lung disease and analysis of its image quality / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To compare the image quality of T grain green sensitive film (TML-1) and Lanex Gd(2)O(2)S rare earth intensifying screen with that of XK-1 blue sensitive film and calcium tungstate (CaWO(4)) intensifying screen, and to study the application of T grain technic to the diagnosis of lung diseases.</p><p><b>METHODS</b>160 coal miners were randomly selected to take both TML-1 and XK-1 chest film of high kV radiographs at the same time. Silver halide granule, fluorescence of intensifying screen, radiographic parameters, the density at different points in the lung and chest radiographs were observed.</p><p><b>RESULTS</b>Silver grains in TML-1 film were more homogeneous in distribution than in XK-1 film. Luminous intensity of Lanex Gd(2)O(2)S rare earth intensifying screen was brighter than CaWO(4) intensifying screen in the same exposure. The exposure doses of TML-1 film was reduced to one third of XK-1 film. The density of chest radiographs was 0.24 to 2.74 in TML-1 film, and 0.30 to 2.60 in XK-1 film. There were greater exposure latitude and more informations in TML-1 film. By apertured-disc observation, the fine structure of lung in TML-1 film was clearer than in XK-1 film, the shape was more concrete and reliable, visualizability was stronger.</p><p><b>CONCLUSION</b>T grain technique may obviously improve the clearness and resolution of image, and enhance the transmission of information, as well as increase the diagnostic informations.</p>