title: [Hard metal lung with diffuse small nodular shadows].
abstract: A 32-year-old woman was admitted to Niigata University Hospital with dyspnea and a non-productive cough. She had been exposed to hard metal dust for 4 years in a metal-polishing factory. Chest X-ray and CT films showed diffuse small nodular shadows in both lung fields and pulmonary-function tests revealed severe restrictive impairment. Specimens obtained by thoracoscopic lung biopsy showed fibrosis in the centers of lobules and in peribronchiolar regions. Giant-cell interstitial pneumonia-like findings were also noted. Tungsten carbide and cobalt were detected in these specimens, with an X-ray microanalyzer. Hard metal lung was diagnosed. By 1 year after she changed her place of work and began corticosteroid treatment her symptoms and pulmonary function had improved remarkably, although shadows on chest X-ray films remained to some extent.
authors.affiliation: Department of Medicine (II), Niigata University School of Medicine, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yokota
authors.forename: T
authors.initials: T
authors.lastname: Hasegawa
authors.forename: S
authors.initials: S
authors.lastname: Murakami
authors.forename: K
authors.initials: K
authors.lastname: Kurashige
authors.forename: M
authors.initials: M
authors.lastname: Maruyama
authors.forename: M
authors.initials: M
authors.lastname: Satoh
authors.forename: E
authors.initials: E
authors.lastname: Suzuki
authors.forename: M
authors.initials: M
authors.lastname: Arakawa
mesh_terms: D000328:Adult; D003035:Cobalt / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging* / Q000209:etiology; D011009:Pneumoconiosis / Q000000981:diagnostic imaging* / Q000209:etiology; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed; D017973:Tungsten Compounds / Q000009:adverse effects*
chemical_list: D017973:Tungsten Compounds; C002802:tungsten carbide; D003035:Cobalt