title: Polishing surgical metal pieces, granulomatosis and mineralogical analysis.
abstract: This report describes the case of a 44-year-old man with pulmonary nodules whose histological analysis initially suggested tuberculosis. The Mycobacterium tuberculosis (MT) culture was negative and a questionnaire revealed a professional activity of brushing and polishing surgical instruments without any protection for 7 years.  A mineralogical analysis by optical and electron microscopy was performed on both a healthy lung tissue biopsy and a lung nodule in a paraffin block. Electron microscopy analysis revealed the presence of metal particles (iron oxide, titanium oxide, aluminum oxide and steel) in both samples. This study suggests that mineralogical analysis combined with a questionnaire on dust exposure could help redirect the diagnosis of a dust-related disease.
authors.affiliation: . mcatinon@ch-stjoseph-stluc-lyon.fr.
authors.forename: Mickaël
authors.initials: M
authors.lastname: Catinon
authors.forename: C
authors.initials: C
authors.lastname: Chemarin
authors.forename: E
authors.initials: E
authors.lastname: Roux
authors.forename: C
authors.initials: C
authors.lastname: Cavalin
authors.forename: P-A
authors.initials: PA
authors.lastname: Rosental
authors.forename: F
authors.initials: F
authors.lastname: Thivolet-Bejui
authors.forename: M
authors.initials: M
authors.lastname: Vincent
mesh_terms: D000328:Adult; D001706:Biopsy; D003937:Diagnosis, Differential; D004391:Dust / Q000032:analysis; D004867:Equipment Design; D005290:Ferric Compounds / Q000009:adverse effects; D015769:Granuloma, Respiratory Tract / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects; D008297:Male; D008670:Metals / Q000009:adverse effects* / Q000032:analysis; D008854:Microscopy, Electron; D055613:Multiple Pulmonary Nodules / Q000139:chemically induced* / Q000175:diagnosis; D009784:Occupational Diseases / Q000139:chemically induced* / Q000175:diagnosis; D016273:Occupational Exposure / Q000009:adverse effects; D016272:Occupational Health; D009790:Occupations; D011237:Predictive Value of Tests; D017565:Sarcoidosis, Pulmonary / Q000139:chemically induced* / Q000175:diagnosis; D013232:Steel / Q000009:adverse effects; D013525:Surgical Instruments / Q000009:adverse effects*; D014025:Titanium / Q000009:adverse effects
chemical_list: D004391:Dust; D005290:Ferric Compounds; D008670:Metals; D013232:Steel; C009495:titanium dioxide; C000499:ferric oxide; D014025:Titanium
keywords: Mineralogical analysis; Occupational disease; Sarcoid-like granulomatous disease