Silicosis - Thoracic Imaging

Title: Thoracic Imaging - Silicosis
Diagnosis: Silicosis
Author: Martins Martina
Comment: Howarth Nigel
Hospital: HUG
Department: Département de Radiologie
State: Terminée
Date: 21.03.2003
: 3438
KeyWords: Silicosis; adenopathies
Anatomy: Thorax
Chapter: Occupational pneumopathy
ACR: 60. 771

Clinical Presentation: Former coal worker.
Comment: Inhaled particles reach the alveoli where they arephagocytosed by
macrophages. Silica is specifically toxic tolysosomal membranes. The release of
intracellular enzymes causesthe lysis of the macrophage. The macrophages undergoing
lysisaccumulate against the alveolar walls before seeping into theinterstitial space where
they trigger a fibroblastic reactionresulting in a silicotic nodule. Chest X-ray findings which
arehighly suggestive of silicosis include: interstitial, micro- ormacronodular, well delineated,
homogeneous opacities and/orreticulated opacities, predominant posteriorly in the apices
and inthe mid-zones of the lungs; homogeneous, confluent, tumour-likeopacities in upper
and posterior territories, representing massesof fibrosis which may contain central or
peripheral calcificationand are sometimes necrotic. Hilar adenopathy is present, with
fineperipheral calcification, producing an egg-shellpattern.
Description: The frontal chest X-ray shows multiple calcifiedmediastinal and hilar
lymph nodes, with dense nodules mainly in theupper lobes.

Order: 0
Dislocation: 0
Polytrauma: 0
Open: 0
Pathologic: 0
Operation: 00.00.00
Graft: 0

References: Remy-Jardin M, Remy J, Farre I, Marquette CH.
Computedtomographic evaluation of silicosis and coal workers'pneumoconiosis. Radiol
Clin North Am. 1992;30:1155-76. Shipley RT.The 1980 ILO classification of radiographs of
the pneumoconioses.Radiol Clin North Am. 1992;30:1135-45.

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