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. 2015:2015:543070.
doi: 10.1155/2015/543070. Epub 2015 Sep 7.

Pulmonary Silicosis Presents with Pleural Effusion

Mohsin Salih  1 , Tarake Aljarod  2 , Mohamed Ayan  3 , Melnick Jeffrey  1 , Bobby H Shah  1
Affiliations

Pulmonary Silicosis Presents with Pleural Effusion

Mohsin Salih et al. Case Rep Med. 2015.

Abstract

Silica and silicate mineral dust inhalation can cause a variety of histopathological changes in the lungs and pleura. These include pulmonary silicotic nodules, interstitial infiltrate, fibrosis, and pleural thickening. Pleural effusion is an extremely rare presentation of silicosis. To our best knowledge, there have been only 2 cases of silicosis with pleural effusion reported in medical literature. Herein, we describe a case of a 77-year-old male with almost 50 years' history of occupational silica exposure. He presented with a 4-week history of exertional shortness of breath. He is a lifetime nonsmoker, with no known other significant pulmonary disease. He had chest X-ray which showed a right lung infiltrate and bilateral pleural thickening and effusion. Chest CT showed moderate-sized bilateral pleural effusion and thickening with multiple bilateral intrapulmonary nodules seen. He had undergone extensive workup and was diagnosed with silicosis.

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Figures

Figure 1
Figure 1
Chest X-ray showed a right lung infiltrate and moderate right pleural effusion, small left pleural effusion, bilateral small irregular opacities, and pleural thickening.
Figure 2
Figure 2
Chest CT showed moderate-sized bilateral pleural effusion and thickening with pulmonary nodules. There is mild interstitial fibrosis. There are multiple bilateral intrapulmonary nodules seen. Some of the nodules are pleural-based. A few nodules do have a small amount of associated calcification.
Figure 3
Figure 3
Lung biopsy showed a silicotic nodule within lung parenchyma composed mainly of bundles of interlacing collagen. There is minimal inflammatory reaction.
Figure 4
Figure 4
Lung biopsy underpolarized microscopy showing bright white silica crystals of varying sizes.
See this image and copyright information in PMC

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