A case of stage Ⅲ pneumoconiosis with large shadow by burr-like changes misdiagnosed as lung cancer / 中华劳动卫生职业病杂志

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.

Magnetic resonance imaging in the diagnosis of large shadow of coal workers' pneumoconiosis and its clinical application / 中国职业医学

OBJECTIVE: To evaluate the clinical application of magnetic resonance imaging( MRI) in diagnosis of lung large shadow in coal workers' pneumoconiosis( CWP). METHODS: Twenty-five CWP patients with lung large shadow( 39 lesions) were selected as CWP group by using the judgment sampling method,and 34 cases( 34 lesions),including 21 cases of lung cancer( lung cancer subgroup) and 13 cases of lung mass( lung mass subgroup),were selected as control group. Routine MRI examinations was performed on these three groups of patients. T1 weighted imaging( T1 WI),T2 weighted imaging( T2 WI) and frequency pre-saturation inversion recovery( SPIR) imagings were performed to analyze the differences of MRI images. RESULTS: Large shadow lesions in patients with CWP showed slightly lower signal,equal signal and equal lower signal in T2 WI and SPIR,accounting for 97. 4%(38/39) and 94. 9%(37/39) respectively. Those show slightly higher signal accounted for 2. 6%(1/39) and 5. 1%(2/39),respectively. The proportions of lung large shadows showed slightly higher signal of CWP group at T2 WI and SPIR were lower than those in the control group( 2. 6% vs88. 2%,5. 1% vs 91. 2%,P < 0. 01),the lung cancer subgroup(2. 6% vs 95. 2%,5. 1% vs 95. 2%,P < 0. 01) and lung mass subgroup( 2. 6% vs 76. 9%,5. 1% vs 84. 6%,P < 0. 01). CONCLUSION: MRI has good specificity in identifying characteristics of lesion of CWP large lung shadow. The main manifestations are slightly lower signal,equal signal and equal lower signal on T2 WI and SPIR