Mixed pneumoconiosis - silicosis with PMF and asbestosis

Case contributed by Chris O'Donnell
Diagnosis almost certain

Presentation

Miner with progressive breathlessness

Patient Data

Age: 80 years
Gender: Male

Mutiple small calcified nodules in the upper zones of both lungs associated with "egg-shell" calcification of mediastinal nodes and a focus of progressive massive fibrosis (not so massive) in the left upper zone posteriorly. These findings are all features of silicosis.  At the bases there are typical features of asbestos exposure including diaphragmatic pleural calcification but no effusion or other features of mesothelioma.

Case Discussion

In miners who have worked for many years in the industry it is not uncommon to have mixed lung disease ie they have had exposure to multiple industrial dusts including silicon and asbestos.

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