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 workers pneumoconiosis and siderosis), vasculitis and vascular metastases, sarcoidosis, hypersensitivity pneumonitis, diffuse panbronchiolitis, and respiratory bronchiolitis-interstitial lung disease (box 1
). 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 workers pneumoconiosis and siderosis).
- Diffuse panbronchiolitis.
- Vasculitis and vascular metastases.
- Sarcoidosis.
- Respiratory bronchiolitis-interstitial lung disease.
- Hypersensitivity pneumonitis
Discussion
Siderosis (synonyms: welders lung, buffers lung, or silver polishers lung) is a non-fibrogenic . . . [Full text of this article]

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Lung nodules in a silver polisher
- S P Bhat, S S Ladhani, and J M Joshi
Postgrad. Med. J. 2002 78: 628.
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