Artificial stone-associated silicosis: clinical-pathological-radiological correlates of disease

Abstract

Occupational lung disease secondary to inhalation of silica particles is variable and potentially life-threatening. As the artificial stone industry has grown over the last two decades, the development of silicosis has been seen to accelerate and behave differently to chronic silicosis. In this case report, we present two patients who underwent lung transplantation for silicosis at the Alfred Hospital, both with predominantly artificial stone masonry exposure. We have identified the presence of both fibrotic/nodular silicosis and conspicuous alveolar proteinosis within the same lung parenchyma of both patients. We then demonstrate the radiological and histopathological correlates of disease; the first time this has been shown clearly in the literature.

Keywords: Alveolar proteinosis; artificial stone; interstitial lung disease; occupational lung disease; silicosis.

Figure 1

Conspicuous areas of alveolar proteinosis (black arrows) corresponding with areas of ground glass changes on computed tomography chest imaging (green arrows). Adjacent parenchyma demonstrates dense fibrosis with silicotic nodules and progressive massive fibrosis (+ and #).

Figure 2

Upper lobe sub‐pleural dense consolidation and fibrosis on computed tomography (CT) chest corresponding with dense conglomerate of nodular and fibrotic silicosis (PMF) on histopathology (blue box and blue arrow). Lower lobe areas of diffuse ground glass changes on CT, corresponding with alveolar proteinosis on histopathology (green box and green arrow).