IMAGE OF THE WEEK

CASEA 52 yr old female patient came with

COMPLAINTS:

Breathlessness

Dry cough on & off for past 6 months

HISTORY:

Had similar episode before 3 years, treated

in stanley – lost records

H/O sputum positive PTB treated with ATT 3

years back

H/O pott’s spine treated 2 years back

Occuptional history:

Working in sand filtration segment in brick production unit.

On examination:

GC good

poorly built & nourished

generalised pigmentation all over body more significant in face

CVS- s1,s2 +

RS – blt wheeze +

PLAIN X RAY

X RAY FINDINGS Plain x ray chest PA view

Centrally placed

Penetration adequte

Rotated to left

Bony structures appear normal

Trachea in midline

Bilateral lung parenchymal radio-opaque lesions seen

Bilateral hilar nodes show well rounded radio-opaque shadow.(calcifications)

Bronchectatic chages in Rt lower lobe

UPPER / MIDDLE LOBE

SECTIONS

LOWER LOBE SECTIONS

IMPRESSION

DIGITAL

X RAY

DD FOR BILATERAL HILAR

CALCIFICATIONS

Sarcoidosis

Silicosis

Post irradiation of hodgkins lymphoma

Blastomycosis

Sleroderma

Histoplasmosis

Amyloidosis

EGG SHELL CALCIFICATION

RADIOLOGICAL CRITERIA

Shell-like calcifications up to 2 mm thick must be present in

the peripheral zone of at least two lymph nodes.

The calcifications may be solid or broken.

In at least one of the lymph nodes the ringlike shadow must

be complete.

The central part of the lymph node may show additional

calcifications.

One of the affected lymph nodes must be at least 1 cm in its

greatest diameter

SLATE GREY

PIGMENTATION

FINAL DIAGNOSIS

OCCUPATIONAL LUNG DISEASE

SILICOSIS

Chronic complicated type- silicotuberculosis

EXPOSURE TO SILVER COMPOUNDS

SILICOSIS

Inhalation of crystalline silica

TYPES:

Chronic – >10 yrs , eggshell calc.

Accelerated – 5-10 yrs , PMF

Acute – silicoproteinosis - hypersensitivity

Complicated – TB , CA

OCCUPATION Mining or tunneling

Quarrying[6]

Drilling

Crushing stone

Chipping

Grinding

Sandblasting

Grinding or polishing in pottery or stone work[7]

Foundry work

Cement manufacturing

Glass manufacturing

Masonry

Blast furnaces

Coal mining

Construction[8]

Cutting or manufacturing heat-resistant bricks

Dental laboratory technician

THANK YOU