A case of mixed dust pneumoconiosis with desquamative interstitial pneumonia-like reaction in an aluminum welder. (2017)

• Record Type: Journal Article
• Authors: Iijima, Yuki; Bando, Masashi; Yamasawa, Hideaki; Moriyama, Hiroshi; Takemura, Tamiko; Niki, Toshiro; Sugiyama, Yukihiko
• Is Part Of: Respiratory medicine case reports. Volume 20(2017)
• Page Start: 150
• Page End: 153
• Publication Date: 2017
• Subjects: Desquamative interstitial pneumonia -- Aluminum lung -- Metal analysis -- Pneumoconiosis; Respiratory organs -- Diseases -- Periodicals; Chest -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Respiratory System -- Periodicals; Chest -- Diseases; Respiratory organs -- Diseases; Electronic journals; Periodicals; 616.2
• DOI: 10.1016/j.rmcr.2017.02.002
• Languages: English
• ISSNs: 2213-0071

Abstract

Abstract: A 60-year-old man presented with an 18-month history of gradually worsening cough and a 12-month history of dyspnea on exertion. High-resolution computed tomography showed bilateral uniform ground grass opacity in the lower lung fields, partially resolved by smoking cessation. A tentative diagnosis of desquamative interstitial pneumonia (DIP) was made. Video-assisted thoracic surgery was performed and pathological analysis showed peribronchiolar fibrosis with intra-alveolar macrophage infiltration. Elemental analysis detected aluminum and iron in the upper lobe and only iron in the lower lobe. Thus, a definitive diagnosis of mixed dust pneumoconiosis with DIP-like reaction was made. DIP-like reaction is known to be a reactive change caused by exposure to tobacco smoke as well as by inhalation of inorganic particles. Obtaining a detailed medical history including occupational and environmental risk factors is important to distinguish cases of DIP-like reaction due to exposure to inorganic particles from the usual cases related to smoking, and thus provide suitable treatment.