Pneumoconiosis: comparison of imaging and pathologic findings

Our plain-English summary of Pneumoconiosis: comparison of imaging and pathologic findings, by S. Chong, K.S. Lee, M.J. Chung, et al (Radiographics, 2006).

The study

• Authors: S. Chong, K.S. Lee, M.J. Chung, J. Han, O.J. Kwon, T.S. Kim
• Journal: Radiographics
• Published: 2006;26(1):59-77
• Type of article: Review
• Cited by: 217 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Pneumoconiosis may be classified as either fibrotic or nonfibrotic, according to the presence or absence of fibrosis. Silicosis, coal worker pneumoconiosis, asbestosis, berylliosis, and talcosis are examples of fibrotic pneumoconiosis. Siderosis, stannosis, and baritosis are nonfibrotic forms of pneumoconiosis that result from inhalation of iron oxide, tin oxide, and barium sulfate particles, respectively. In an individual who has a history of exposure to silica or coal dust, a finding of nodular or reticulonodular lesions at chest radiography or small nodules with a perilymphatic distribution at thin-section computed tomography (CT), with or without eggshell calcifications, is suggestive of silicosis or coal worker pneumoconiosis. Magnetic resonance imaging is helpful for distinguishing between progressive massive fibrosis and lung cancer. CT and histopathologic findings in asbestosis are similar to those in idiopathic pulmonary fibrosis, but the presence of asbestos bodies in histopathologic specimens is specific for the diagnosis of asbestosis. Giant cell interstitial pneumonia due to exposure to hard metals is classified as a fibrotic form of pneumoconiosis and appears on CT images as mixed ground-glass opacities and reticulation. Berylliosis simulates pulmonary sarcoidosis on CT images. CT findings in talcosis include small centrilobular and subpleural nodules or heterogeneous conglomerate masses that contain foci of high attenuation indicating talc deposition. Siderosis is nonfibrotic and is indicated by a CT finding of poorly defined centrilobular nodules or ground-glass opacities.

(c) RSNA, 2006.

In plain English

This article was an educational review, presented as an education exhibit at the 2004 RSNA Annual Meeting. It was not a study of a defined group of patients. The authors surveyed chest radiograph, CT and pathology findings in several dust-related lung diseases. They illustrated these with individual patient cases, among them asbestosis in men who had worked in building construction, at an automobile factory and in a shipyard. The authors classed silicosis, coal worker pneumoconiosis, asbestosis, berylliosis and talcosis as fibrotic forms. They stated that no chest radiograph finding is pathognomonic of asbestosis, and that CT and tissue findings in asbestosis resemble those in idiopathic pulmonary fibrosis. In their account, parietal pleural thickening together with lung fibrosis was highly suggestive of asbestosis in people with a history of asbestos exposure, and asbestos bodies in tissue were specific for the diagnosis. Citing earlier work, they noted a latency of at least 20 years between first asbestos exposure and lung carcinoma or pleural mesothelioma. The authors concluded that diagnosis should combine occupational exposure history with pathologic and radiologic findings.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Educational review (education exhibit) of imaging and pathologic findings in pneumoconiosis, illustrated with individual cases
• Who was studied: No study cohort. The review used illustrative individual cases from the authors' institution in Seoul, Korea, and from other contributors. The asbestosis cases were men aged 58, 59 and 70 who had worked in building construction (25 years), at an automobile factory (30 years) and in a shipyard (30 years).
• Exposure: Inhaled mineral and metal dusts: silica, coal dust, asbestos, beryllium, hard metals, talc (including talc with asbestos fibers), iron oxide, tin oxide and barium sulfate. The review named chrysotile, crocidolite and amosite as asbestos-containing materials widely used in industry.
• Main results:
  • The authors classed silicosis, coal worker pneumoconiosis, asbestosis, berylliosis and talcosis as fibrotic forms of pneumoconiosis. They classed siderosis, stannosis and baritosis as nonfibrotic forms.
  • The authors stated that no radiographic findings are pathognomonic of asbestosis.
  • CT and histopathologic findings in asbestosis were described as similar to those in idiopathic pulmonary fibrosis, while asbestos bodies in histopathologic specimens were described as specific for asbestosis.
  • Parietal pleural thickening together with lung fibrosis was described as the most important feature distinguishing asbestos-induced fibrosis from idiopathic pulmonary fibrosis. It was called highly suggestive of asbestosis in patients with a history of asbestos exposure.
  • Citing earlier work, the review stated there is a latency of at least 20 years between initial asbestos exposure and the development of a pulmonary carcinoma or pleural mesothelioma.
  • The review listed inhalation of talc in association with asbestos fibers (talcoasbestosis) as one recognized cause of pulmonary talcosis.
• The authors' conclusion: The authors concluded that a diagnosis of pneumoconiosis should integrate a history of occupational exposure to inorganic dusts or fumes with the pathologic and radiologic findings.

Topics

Medical terms in this study, explained in our Lexicon: Pneumoconiosis, Fibrosis, Silicosis, Lung Cancer, Idiopathic, Pulmonary Fibrosis, Asbestos Bodies, Interstitial.

Related studies

• Talc pneumoconiosis: a report of six patients with postmortem findings — M. Kleinfeld, C.P. Giel, et al. (1963)
• Induction of thoracic malignancy in inorganic dust pneumoconiosis — J.C. Scatarige, F.P. Stitik (1988)
• Talc pneumoconiosis — A.I. McLAUGHLIN, E. Rogers, et al. (1949)
• 24 years of pneumoconiosis mortality surveillance in Australia — D.R. Smith, P.A. Leggat (2006)
• Mixed pneumoconiosis: silicosis, asbestosis, talcosis, and berylliosis — G.J. Mark, C.B. Monroe, et al. (1979)
• Talc pneumoconiosis in the textile industry — B. Mann, J.B. Deasy (1954)

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