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Postgraduate Medical Journal 2002;78:631-632; doi:10.1136/pmj.78.924.631-a
Copyright © 2002 The Fellowship of Postgraduate Medicine.
Postgraduate Medical Journal 2002;78:631-632
© 2002 The Fellowship of Postgraduate Medicine

Lung nodules in a silver polisher

The first 150 words of the full text of this article appear below.

Q1: What do the chest radiograph and HRCT of the lung show (see p 628)?

The chest radiograph shows nodular opacities, predominantly in the upper lobes. The HRCT lung images show diffusely distributed centrilobular nodules without any evidence of fibrosis.

Q2: What is the differential diagnosis of the HRCT scan appearance and the likely diagnosis in this case?

The differential diagnosis of centrilobular nodules with diffuse distribution on HRCT lung scan (see p 628) are infectious bronchiolitis including tuberculosis, pneumoconiosis (coal worker’s pneumoconiosis and siderosis), vasculitis and vascular metastases, sarcoidosis, hypersensitivity pneumonitis, diffuse panbronchiolitis, and respiratory bronchiolitis-interstitial lung disease (box 1Go). The diagnosis in this case was siderosis in view of the clinical presentation, occupational history of prolonged exposure to iron oxide during silver polishing, and characteristic appearance of centrilobular nodules on HRCT of the lungs.


Box 1: Differential diagnosis of centrilobular nodules on HRCT lung scan

  • Infectious bronchiolitis including tuberculosis.
  • Pneumoconiosis (coal worker’s pneumoconiosis and siderosis).
  • Diffuse panbronchiolitis.
  • Vasculitis and vascular metastases.
  • Sarcoidosis.
  • Respiratory bronchiolitis-interstitial lung disease.
  • Hypersensitivity pneumonitis


Discussion

Siderosis (synonyms: welder’s lung, buffer’s lung, or silver polisher’s lung) is a non-fibrogenic . . . [Full text of this article]


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Relevant Article

Lung nodules in a silver polisher
S P Bhat, S S Ladhani, and J M Joshi
Postgrad. Med. J. 2002 78: 628. [Extract] [Full Text] [PDF]

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