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Flashcards in Pneumoconioses Deck (16):
0

Pneumoconiosis
- restrictive lung diseases/ chronic fibrotic occupational lung disease

Dust lung
10-20 years exposure
Permanent parenchymal fibrotic change
Restrictive lung diseases
Eg. Silicosis
Asbestosis
Coal worker's pneumoconiosis
Beryllium
Hard metals (cobalt-tungsten carbide)

1

Silicosis

- Small rounded opaque and progress to confluent opacities, to progressive massive fibrosis
- Upper lung small rounded nodules
- Increased risk of TB infection
- Restrictive lung disease
- Silica is carcinogenic

2

Coal workers' pneumoconiosis

- Macule loaded with coal dust
- Less fibrogenic than silica

3

Asbestos diseases

1. Asbestosis (remember! This refers to the pneumoconiosis)
2. Benign pleural effusion (1st manifestation of asbestos exposure after about 10 years of exposure)
3. Pleural plaques
4. Lung cancer
5. Mesothelioma

4

Asbestos

- Serpentine (curly fibers) (chrysotile) - most in use ( 95%)
- Amphibole ( needle like) - more carcinogenic

Latency - at least 20 years

5

Asbestosis chest x- ray

Small irregular or linear opacities, fibrosis, esp. at the base of the lung

(Compare to silicosis - small rounded opacities mainly in upper lobes)

6

Asbestos pathology

Asbestos body
= protein coated fiber which contains iron (ferruginous body)

- only pathological feature unique to asbestosis

7

Bilateral Upper lung small rounded nodules in x-ray

Silicosis

8

Bilateral linear fibrotic changes in the lower lobe

Asbestosis

9

Asbestos + tobacco

1. Increases susceptibility for asbestosis
2. Increases risk for bronchogenic cancer
3. Increased risk for cancer of esophagus, oropharynx and larynx among smokers

(Not for mesothelioma)

10

Synergistic risk of asbestos and smoking for lung cancer

Non-smoker, non-asbestos exposure: RR = 1 (ref)
Asbestos workers: RR = 5.2
Smokers: RR = 10.8
Smokers+asbestos: RR = 53.2

11

Egg shell calcification on x-Ray

Silicosis
- silica can be transported by macrophages via pulmonary lymphatics to the hilar nodes, that appear as "egg shell calcifications" on x- ray

12

Fibrosis and small rounded opacities without hilar node calcification on x-ray?

Coal worker's pneumoconiosis

13

Non-caseating granulomatous lesions in the lungs

Beryllium disease
Sarcoidosis

14

Beryllium lung disease CXR

Upper to middle love interstitial infiltrates, hilar adenopathy

15

Which of the dusts causes pulmonary fibrosis, rather than simple pneumoconiosis?

Bagasse