Presentation
Two months history of dry cough
Patient Data
Multiple small lung nodules are noted bilaterally predominantly in the upper lobes with nodular thickening of the peribronchovascular interstitium, and calcified hilar and mediastinal lymphadenopathy.
A cavitary lesion is noted in the apical segment of the right lower lobe with surrounding lung consolidation as well as centrilobular nodules with a linear branching pattern giving the classical 'tree-in-bud' appearance.
Case Discussion
The association of multiple and bilateral small lung nodules predominantly in the upper lobes with calcified hilar and mediastinal lymphadenopathy in a patient with a history of exposure to silica particles (15 years as a stone carver in this case) is highly suggestive of silicotuberculosis.
Pulmonary tuberculosis is reported in the literature to be more common in patients with silicosis 1.
Additional contributor: R Bouguelaa, MD
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