ABSTRACT
Pneumoconiosis is characterized by chronic lung inflammation and fibrosis, and inflammation can promote pulmonary fibrosis, which in turn leads to pneumoconiosis. When a large shadow with a long diameter of not less than 2 cm and a short diameter of not less than 1 cm appears in the lung, it can be classified as stage Ⅲ pneumoconiosis. This paper reports a case of stage Ⅲ pneumoconiosis with a large shadow in the upper right lung accompanied by burr-like changes misdiagnosed as lung cancer by CT examination.When the large shadow lesions in patients with pneumoconiosis and lung cancer are difficult to distinguish on CT, an additional MRI examination, particularly T(2)W imaging sequence is useful sequence for identifying the two.
Subject(s)
Humans , Pneumoconiosis/pathology , Lung/pathology , Lung Neoplasms/pathology , Pulmonary Fibrosis/pathology , Diagnostic ErrorsABSTRACT
Occupational pneumoconiosis is one of the main occupational diseases in China. Progressive massive fibrosis in pneumoconiosis should be distinguished from lung cancer for their similar imaging features which is often identified by (18)F-FDG PET-CT in clinic. Here we reported two cases of pneumoconiosis. Both of them were suspected of carrying malignant tumors by preoperative PET-CT exam, however, nodules in these two patients were all proved to be benign by intraoperative pathology which suggested that there is false-positive possibility in the distinguishment of pneumoconiosis nodules by (18)F-FDG PET-CT.
Subject(s)
Humans , Fibrosis , Fluorodeoxyglucose F18 , Lung Neoplasms/pathology , Pneumoconiosis/pathology , Positron Emission Tomography Computed Tomography , Positron-Emission Tomography/methodsABSTRACT
A pneumoconiose por metal duro, descrita pela primeira vez em 1964, é uma doença difusa causada por inalação de partículas de cobalto. A doença pode se manifestar de três formas diferentes: asma ocupacional, doença intersticial e alveolite alérgica. Relata-se um caso de um jovem do sexo masculino, afiador de ferramentas, com quadro de tosse seca e dispnéia progressiva há um ano, apresentando-se à admissão com pneumotórax espontâneo bilateral. O diagnóstico foi confirmado através de biópsia pulmonar a céu aberto.
Hard metal pneumoconiosis, first described in 1964, is a diffuse disease caused by the inhalation of cobalt particles. The disease can manifest as occupational asthma, interstitial disease or allergic alveolitis. We report the case of a young male, working as a tool sharpener, who presented with dry cough and progressive dyspnea for one year, as well as with spontaneous bilateral pneumothorax at admission. The diagnosis was confirmed by open lung biopsy.
Subject(s)
Adult , Humans , Male , Alloys/toxicity , Cobalt/toxicity , Occupational Exposure , Pneumoconiosis/pathology , Pneumothorax/etiology , Tungsten/toxicity , Pneumoconiosis/complicationsABSTRACT
VDVB, 38 anos, masculino, há 5 anos trabalha com jatos de areia. Em julho/2007 paciente referiu dispnéiade instalação súbita, associada à tosse seca, sudorese noturna e astenia. Há 4 meses teve perda ponderal de 10 quilos. Foi internado em franca insuficiência respiratória. Não apresenta comorbidades nem faz uso de medicações. Ao exame físico apresentou taquidispnéia (freqüência respiratória: 40mpm), taquicardia (freqüência cardíaca: 135bpm), tiragens intercostais, estertoração crepitanteem bases pulmonares, diminuição de murmúrios vesiculares à direita e saturação de oxigênio de 86%.Ao RX de tórax havia condensações alveolares difusas bilaterais e de aspecto confluente peri-hilar e basal direito. BAAR negativo. PPD não-reator. Ecocardiograma mostrou tronco da artéria pulmonar e calibre mantidos,fração de ejeção de 59% e prolapso de válvula mitral. À tomografia computadorizada, firmou-se o diagnóstico de pneumoconiose, devido à presença de micronódulosconfluentes formando massas parenquimatosas e subpleurais, com presença de adenomegalia para-hilar;cavitações ausentes. Medicações em uso no momento da internação: atrovent, berotec, meticorten, talofilina.Após compensação da insuficiência respiratória e paciente teve alta hospitalar e foi orientado quanto à irreversibilidade caso e a possibilidade de transplante pulmonar.
Subject(s)
Humans , Male , Middle Aged , Cough , Dyspnea , Pneumoconiosis , Silicosis , Weight Loss , Dyspnea/complications , Pneumoconiosis/diagnosis , Pneumoconiosis/history , Pneumoconiosis/pathology , Silicosis/complications , Cough/complicationsABSTRACT
This study describes the quantitative relationships between early pulmonary responses and the estimated lung-burden or cumulative exposure of respirable-quartz or coal mine dust. Data from a previous bronchoalveolar lavage (BAL) study in coal miners (n = 20) and nonminers (n = 16) were used including cell counts of alveolar macrophages (AMs) and polymorphonuclear leukocytes (PMNs), and the antioxidant superoxide dismutase (SOD) levels. Miners' individual working lifetime particulate exposures were estimated from work histories and mine air sampling data, and quartz lung-burdens were estimated using a lung dosimetry model. Results show that quartz, as either cumulative exposure or estimated lung-burden, was a highly statistically significant predictor of PMN response (P < 0.0001); however cumulative coal dust exposure did not significantly add to the prediction of PMNs (P = 0.2) above that predicted by cumulative quartz exposure (P < 0.0001). Despite the small study size, radiographic category was also significantly related to increasing levels of both PMNs and quartz lung burden (P-values < 0.04). SOD in BAL fluid rose linearly with quartz lung burden (P < 0.01), but AM count in BAL fluid did not (P > 0.4). This study demonstrates dose-response relationships between respirable crystalline silica in coal mine dust and pulmonary inflammation, antioxidant production, and radiographic small opacities.
Subject(s)
Adult , Air Pollutants, Occupational/analysis , Antioxidants/metabolism , Bronchoalveolar Lavage Fluid/cytology , Cell Count , Coal Mining , Dose-Response Relationship, Drug , Dust/analysis , Humans , Inflammation , Linear Models , Macrophages, Alveolar/metabolism , Male , Neutrophils/metabolism , Pneumoconiosis/pathology , Quartz/adverse effects , Retrospective Studies , Superoxide Dismutase/analysisABSTRACT
Apresenta-se o primeiro caso brasileiro de bagaçose, histologicamente documentado. A imunofluorescência direta da biopsia pulmonar revelou ausência de complexos antígeno-anticorpo. Acredita-se que a patogenia da doença é devida a reaçäo de hipersensibilidade retardada a antígenos de bolores presentes nas fibras do bagaço aspirado