title: CT-guided aspiration cytology of advanced silicosis and confirmation of the deposited zeolite nano particles through X ray diffraction: A novel approach.
abstract: Silicosis is a common occupational lung disease, resulting in fibrotic nodular lesions in the upper lobes of the lung parenchyma. Most of the pneumoconioses are diagnosed on the basis of relevant history and clinico-radiological correlation. Image-guided aspiration cytology appears to be poorly yielding and is not usually considered as a diagnostic modality. However, silicosis may sometimes offer a diagnostic challenge because of its radiological resemblance and clinical overlap with pulmonary tuberculosis and neoplastic lesions. We present a unique situation where image-guided fine needle aspiration cytology (FNAC) has been advised on the basis of nodular upper lobe opacities. The cytology smears revealed hypocellular granular material, while phase contrast and polarized light microscopy highlighted crystalline particles. History of silica dust exposure long back was available after the cytological evaluation, suggesting the diagnosis of pulmonary silicosis. X ray diffraction (XRD) crystallography was also possible on cytology smears, confirming zeolite nano particles of size as small as 40 - 50 nm as the concerned agent for the first time. Cytological evaluation by phase contrast and polarized light microscopy may be useful for the confirmation of silicosis, supplemented by clinical history and radiological evaluation. XRD on smears may help in determination of chemical nature and particle size.
authors.affiliation: Department of Pathology, Burdwan Medical College, The West Bengal University of Health Sciences, Burdwan, India.
authors.forename: Arghya
authors.initials: A
authors.lastname: Bandyopadhyay
authors.affiliation: Department of Pathology, Delhi University, G B Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India.
authors.forename: Kaushik
authors.initials: K
authors.lastname: Majumdar
authors.affiliation: Department of Physics, the University of Burdwan, Burdwan, India.
authors.forename: Abhijit
authors.initials: A
authors.lastname: Chakraborty
authors.affiliation: Department of Physics, the University of Burdwan, Burdwan, India.
authors.forename: Partha
authors.initials: P
authors.lastname: Mitra
authors.affiliation: Department of Radiology, Burdwan Scan Centre, Burdwan, India.
authors.forename: Subhomoy
authors.initials: S
authors.lastname: Nag
mesh_terms: D044963:Biopsy, Fine-Needle; D006801:Humans; D061705:Image-Guided Biopsy; D008297:Male; D008875:Middle Aged; D053758:Nanoparticles / Q000737:chemistry / Q000633:toxicity*; D012829:Silicosis / Q000209:etiology / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D014961:X-Ray Diffraction; D017641:Zeolites / Q000633:toxicity*
chemical_list: D017641:Zeolites
keywords: CT-guided FNAC; X-ray diffraction; silicosis; zeolite