Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2018; 6(16): 1164-1168
Published online Dec 26, 2018. doi: 10.12998/wjcc.v6.i16.1164
Combined silicosis and mixed dust pneumoconiosis with rapid progression: A case report and literature review
Hee-Young Yoon, Yookyung Kim, Heae Surng Park, Chung-Won Kang, Yon Ju Ryu
Hee-Young Yoon, Yon Ju Ryu, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul 15871, South Korea
Yookyung Kim, Department of Radiology, Ewha Womans University, College of Medicine, Seoul 15871, South Korea
Heae Surng Park, Department of Pathology, Ewha Womans University, College of Medicine, Seoul 15871, South Korea
Chung-Won Kang, Department of Occupational and Environmental Medicine, Ewha Womans University College of Medicine, Seoul 15871, South Korea
Author contributions: Yoon HY and Ryu YJ take full responsibility for the content of this manuscript, including its data; Kim Y and Park HS interpreted radiological and pathological findings, respectively; Kang CW revised the manuscript; all authors discussed the results and reviewed the manuscript.
Informed consent statement: The study participant provided informed written consent prior to study enrollment.
Conflict-of-interest statement: None declared.
CARE Checklist (2016) statement: The authors wrote and revised the manuscript according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author to: Yon Ju Ryu, MD, PhD, Professor, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Ewha Womans University, Mokdong Hospital, Mok 5-dong, Yangcheon-gu, Seoul 15871, South Korea. medyon@ewha.ac.kr
Telephone: +82-2-26502840 Fax: +82-2-26502559
Received: September 29, 2018
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
Processing time: 86 Days and 18.2 Hours
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

In this case, mixed dust pneumoconiosis with silicosis might be accelerated by persistent exposure to grain dust from working in a mill environment.

Keywords: Pathology; Case report; Pneumoconiosis; Silicosis; Dust; Occupational diseases

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.