Pneumoconiosis with a Sarcoid-Like Reaction Other than Beryllium Exposure: A Case Report and Literature Review
| Autor: | Yoshinobu Eishi, Fumiko Hayashi, Mitsuru Yokoyama, Hiroshi Ishimoto, Yuji Ishimatsu, Hiroshi Mukae, Hiroyuki Yamaguchi, Taiga Miyazaki, Mutsumi Ozasa, Yasushi Obase, Junya Fukuoka, Atsuko Hara, Yoshiaki Zaizen, Noriho Sakamoto, Hirokazu Yura, Takashi Kido |
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| Rok vydání: | 2020 |
| Předmět: |
Medicine (General)
Pathology medicine.medical_specialty pneumoconiosis Berylliosis Radiography berylliosis Case Report chronic beryllium disease R5-920 medicine sarcoidosis Lung business.industry Pneumoconiosis X-ray analytical electron microscopy General Medicine medicine.disease respiratory tract diseases medicine.anatomical_structure Lymphatic system aluminum sarcoid-like reaction Etiology Sarcoidosis business Beryllium Disease |
| Zdroj: | Medicina Medicina, Vol 56, Iss 630, p 630 (2020) |
| ISSN: | 1648-9144 |
| DOI: | 10.3390/medicina56110630 |
| Popis: | Background: Chronic beryllium disease (CBD) is a granulomatous disease that resembles sarcoidosis but is caused by beryllium. Clinical manifestations similar to those observed in CBD have occasionally been reported in exposure to dusts of other metals. However, reports describing the clinical, radiographic, and pathological findings in conditions other than beryllium-induced granulomatous lung diseases, and detailed information on mineralogical analyses of metal dusts, are limited. Case presentation: A 51-year-old Japanese man with rapidly progressing nodular shadows on chest radiography, and a 10-year occupation history of underground construction without beryllium exposure, was referred to our hospital. High-resolution computed tomography showed well-defined multiple centrilobular and perilobular nodules, and thickening of the intralobular septa in the middle and lower zones of both lungs. No extrathoracic manifestations were observed. Pathologically, the lung specimens showed 5–12 mm nodules with dust deposition and several non-necrotizing granulomas along the lymphatic routes. X-ray analytical electron microscopy of the same specimens revealed aluminum, iron, titanium, and silica deposition in the lung tissues. The patient stopped smoking and changed his occupation to avoid further dust exposure; the chest radiography shadows decreased 5 years later. Conclusion: The radiological appearances of CBD and sarcoidosis are similar, although mediastinal or hilar lymphadenopathy is less common in CBD and is usually seen in the presence of parenchymal opacities. Extrathoracic manifestations are also rare. Despite limited evidence, these findings are similar to those observed in pneumoconiosis with a sarcoid-like reaction due to exposure to dust other than of beryllium. Aluminum is frequently detected in patients with pneumoconiosis with a sarcoid-like reaction and is listed as an inorganic agent in the etiology of sarcoidosis. It was also detected in our patient and may have contributed to the etiology. Additionally, our case suggests that cessation of dust exposure may contribute to improvement under the aforementioned conditions. |
| Databáze: | OpenAIRE |
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