Published online Dec 26, 2018. doi: 10.12998/wjcc.v6.i16.1164
Peer-review started: September 29, 2018
First decision: October 18, 2018
Revised: November 7, 2018
Accepted: November 7, 2018
Article in press: November 7, 2018
Published online: December 26, 2018
Rapidly progressive pneumoconiosis (RPP) occasionally occurs in coal workers, particularly those with high exposure to silica. Here, we report the case of a 64-year-old male miller with RPP.
The patient had a persistent cough for one month and had been clinically diagnosed with pulmonary tuberculosis in 2011. He worked in a stone processing factory from the ages of 20 through 37 and has owned his own mill for the past 25 years. His chest radiograph showed significant increases in the size and number of lung nodules since his last follow-up in 2013. By percutaneous needle lung biopsy, the nodular lesions showed diffuse infiltration of phagocytic macrophages and birefringent crystals by polarizing microscopy. He was finally diagnosed with RPP of mixed dust pneumoconiosis combined with silicosis.
In this case, mixed dust pneumoconiosis with silicosis might be accelerated by persistent exposure to grain dust from working in a mill environment.
Core tip: Silicosis progresses slowly over a period of more than a decade and can occur after silica exposure has ceased. Pneumoconiosis including silicosis occasionally shows rapid imaging progression, and the risk factors for its progression are well defined. This case report describes the association of rapid progression pneumoconiosis with grain dust exposure. In this case, silicosis rapidly developed upon exposure to a small amount of silica mixed with other dust even long after ending excessive silica exposure. Thus, it is important to carefully study a patient’s history and consider pneumoconiosis.