Answer to Quiz No. 103 dated 18 June 2017
Complicated type of Silico-Tuberculosis
Findings
Chest X- Ray PA View: Multiple ill defined nodular opacities ; few of them coalesces to form mass like lesion predominantly in the upper and middle zone on both lung fields, sparing the lower zone. Multiple enlarged and calcified mediastinal lymphonodes with few of them showing egg- shell calcification. CT Chest Findings: Multiple soft tissue density large nodular lesions with traction bronchiectasis noted predominantly in the b/l upper lobes. Few nodules shows cavitation. Also Multiple small centilobular nodules showing tree in bud appearance noted in bilateral lung fieds. Multiple calcified hilar, paratracheal and subcarinal lymphnodes noted.
Discussion
Silicosis is caused by inhalation of dust containing silica (silicon dioxide or Si02). Heavy-metal mining and hard-rock mining are the occupations most frequently associated with chronic silicosis. TYPES : Acute Silicosis (Silicoproteinosis) Simple Silicosis Complicated Silicosis – OUR CASE In patients with complicated silicosis, these masses represent a conglomeration of numbers of silicotic nodules associated with dense fibrous tissue (progressive massive fibrosis). Cavitation is related to ischemia, tuberculosis like in our CASE (which has an increased incidence in both silicosis and CWP), or anaerobic bacterial infection.
References
Webb - Thoracic Imaging Pneumoconiosis - Comparision of Imaging and Pathologic findings: rsna article. Grainger & Allison's
Findings
Chest X- Ray PA View: Multiple ill defined nodular opacities ; few of them coalesces to form mass like lesion predominantly in the upper and middle zone on both lung fields, sparing the lower zone. Multiple enlarged and calcified mediastinal lymphonodes with few of them showing egg- shell calcification. CT Chest Findings: Multiple soft tissue density large nodular lesions with traction bronchiectasis noted predominantly in the b/l upper lobes. Few nodules shows cavitation. Also Multiple small centilobular nodules showing tree in bud appearance noted in bilateral lung fieds. Multiple calcified hilar, paratracheal and subcarinal lymphnodes noted.
Discussion
Silicosis is caused by inhalation of dust containing silica (silicon dioxide or Si02). Heavy-metal mining and hard-rock mining are the occupations most frequently associated with chronic silicosis. TYPES : Acute Silicosis (Silicoproteinosis) Simple Silicosis Complicated Silicosis – OUR CASE In patients with complicated silicosis, these masses represent a conglomeration of numbers of silicotic nodules associated with dense fibrous tissue (progressive massive fibrosis). Cavitation is related to ischemia, tuberculosis like in our CASE (which has an increased incidence in both silicosis and CWP), or anaerobic bacterial infection.
References
Webb - Thoracic Imaging Pneumoconiosis - Comparision of Imaging and Pathologic findings: rsna article. Grainger & Allison's
