A case of mixed dust pneumoconiosis with desquamative interstitial pneumonia-like reaction in an aluminum welder

Abstract A 60-year-old man presented with an 18-month history of gradually worsening cough and a 12-month history of dyspnea on exertion. High-resolution computed tomography showed bilateral uniform ground grass opacity in the lower lung fields, partially resolved by smoking cessation. A tentative d...

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Bibliographic Details
Published in:Respiratory medicine case reports 2017-01, Vol.20 (C), p.150-153
Main Authors: Iijima, Yuki, Bando, Masashi, Yamasawa, Hideaki, Moriyama, Hiroshi, Takemura, Tamiko, Niki, Toshiro, Sugiyama, Yukihiko
Format: Article
Language:English
Subjects:
Aluminum lung
Case Report
Desquamative interstitial pneumonia
Internal Medicine
Metal analysis
Pneumoconiosis
Pulmonary/Respiratory
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Summary:Abstract A 60-year-old man presented with an 18-month history of gradually worsening cough and a 12-month history of dyspnea on exertion. High-resolution computed tomography showed bilateral uniform ground grass opacity in the lower lung fields, partially resolved by smoking cessation. A tentative diagnosis of desquamative interstitial pneumonia (DIP) was made. Video-assisted thoracic surgery was performed and pathological analysis showed peribronchiolar fibrosis with intra-alveolar macrophage infiltration. Elemental analysis detected aluminum and iron in the upper lobe and only iron in the lower lobe. Thus, a definitive diagnosis of mixed dust pneumoconiosis with DIP-like reaction was made. DIP-like reaction is known to be a reactive change caused by exposure to tobacco smoke as well as by inhalation of inorganic particles. Obtaining a detailed medical history including occupational and environmental risk factors is important to distinguish cases of DIP-like reaction due to exposure to inorganic particles from the usual cases related to smoking, and thus provide suitable treatment.
ISSN:2213-0071
2213-0071
DOI:10.1016/j.rmcr.2017.02.002