Progressive massive fibrosis in silica-exposed workers. High-resolution computed tomography findings.
OBJECTIVE
To evaluate the radiological characteristics of conglomerate masses using high-resolution computed tomography of the chest.


METHODS
From among the patients treated between 1986 and 2004 at the Antonio Pedro University Hospital, 75 patients with silicosis and massive fibrosis, most working in the field of sandblasting, were selected for study. These patients were submitted to a clinical evaluation, chest X-ray and high-resolution computed tomography of the chest.


RESULTS
In more than half of the patients with accelerated silicosis, the chest X-ray revealed large type B and C opacities, denoting the severity of the disease in those patients. In 1 case, a unilateral mass simulating lung cancer was observed. High-resolution computed tomography scans of the chest were acquired for 44 patients. In most cases (88.6%), the masses were located in the superior and posterior thirds of the lung. Common findings within the masses included air bronchograms (in 70.4%) and calcifications (in 63.6%). A history of tuberculosis was reported by 52% of the patients.


CONCLUSIONS
In the vast majority of cases, the masses were bilateral, predominantly located in the superior and posterior regions of the lung, featuring air bronchograms and interposed calcifications. Concomitant calcification of the mediastinal and hilar lymph nodes was another common finding. Exposure to high concentrations of dust and having a history of tuberculosis were considered significant risk factors for the development of progressive massive fibrosis.
Ferreira
Angela Santos
AS
Universidade Federal Fluminense, Niterói, RJ, Brasil. anani@predialnet.com.br
Moreira
Valéria Barbosa
VB
Ricardo
Hevânia Mara Vaz
HM
Coutinho
Renata
R
Gabetto
José Manoel
JM
Marchiori
Edson
E
D000328:Adult; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects*; D011658:Pulmonary Fibrosis / Q000000981:diagnostic imaging* / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012829:Silicosis / Q000150:complications / Q000000981:diagnostic imaging*; D012830:Silicotuberculosis / Q000000981:diagnostic imaging / Q000209:etiology; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*