Computed Tomography Findings in Progressive Massive Fibrosis: Analyses of 90 Cases CT Findings in PMF

Main Article Content

Gülden Sarı
Atila Gökçek https://orcid.org/0000-0002-5378-5871
Adem Koyuncu https://orcid.org/0000-0003-4834-1317
Cebrail Şimşek https://orcid.org/0000-0003-4767-6393

Keywords

pneumoconiosis, progressive massive fibrosis, Computed Tomography, silicosis, spirometry

Abstract

Purpose: Radiological identification of lung masses in patients with pneumoconiosis is difficult. The aim of the study is to characterize Computed Tomography (CT) findings of Progressive Massive Fibrosis (PMF). Methods: The data of pneumoconiosis patients, who were diagnosed with PMF between 2014-2019 in a tertiary hospital, were collected. Demographic data, work-related data, Pulmonary Function Test results and radiological imaging results were gathered. Separate evaluations were made for the right and left lungs, and the CT findings and measurement results were recorded. Results: In 90% of our cases, PMF lesions were bilaterally located. Eighty-eight point five percent of the unilateral lesions were located in the upper lobe of the right lung. Enlarged lymph nodes were found in 83.3% and calcification was found in the lymph nodes in 63% of the cases. Band structures extending between the PMF lesion and the adjacent pleura were observed in 86% of the cases, and invagination in the lung parenchyma adjacent to the PMF was observed in 80% of the cases. Conclusion: In general, our findings were consistent with the radiologically defined PMF. In addition, pleural findings, which are not frequently studied in the literature except for asbestosis, were also described in the study.


Methods: The data of pneumoconiosis patients, who were diagnosed with PMF between 2014-2019 in a tertiary hospital, were collected. Demographic data, work-related data, PFT results and radiological imaging results were noted. Separate evaluations were made for the right and left lungs, and the CT findings and measurement results were recorded.


Results: In 90% of our cases, PMF lesions were bilaterally located. 88.8% of the unilateral lesions were located in the upper lobe of the right lung. Enlarged lymph nodes were found in 83.3% and calcification was found in the lymph nodes in 63% of the cases. Band structures extending between the PMF lesion and the adjacent pleura were observed in 86% of the cases, and invagination in the lung parenchyma adjacent to the PMF was observed in 80% of the cases.


Conclusion: In general, our findings were consistent with the radiologically defined PMF. In addition, pleural findings, which are not frequently studied in the literature except asbestosis, were also described in the study.

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References

1. Organization IL. Report of the Working Party on the Definition of Pneumoconiosis. . Fourth International Pneumoconiosis Conference; Geneva, Switzerland1971.
2. Naghavi M, Abajobir AA, Abbafati C, Abbas KM, Abd-Allah F, Abera SF, et al. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet. 2017;390(10100):1151-210.
3. dos Santos Antao VC, Pinheiro GA, Terra-Filho M, Kavakama J, Müller NL. High-resolution CT in silicosis: correlation with radiographic findings and functional impairment. Journal of computer assisted tomography. 2005;29(3):350-6.
4. Bergin C, Muller N, Vedal S, Chan-Yeung M. CT in silicosis: correlation with plain films and pulmonary function tests. American journal of roentgenology. 1986;146(3):477-83.
5. Bégin R, Ostiguy G, Fillion R, Colman N. Computed Tomography Scan in the Early Detection of Silicosis1, 2. Am Rev Respir Dis. 1991;144:697-705.
6. Talini D, Paggiaro PL, Falaschi F, Battolla L, Carrara M, Petrozzino M, et al. Chest radiography and high resolution computed tomography in the evaluation of workers exposed to silica dust: relation with functional findings. Occupational and environmental medicine. 1995;52(4):262-7.
7. Chong S, Lee KS, Chung MJ, Han J, Kwon OJ, Kim TS. Pneumoconiosis: Comparison of Imaging and Pathologic Findings. RadioGraphics. 2006;26(1):59-77.
8. Organization IL. GUIDELINES FOR THE USE OF THE ILO INTERNATIONAL CLASSIFICATION OF RADIOGRAPHS OF PNEUMOCONIOSES: OCCUPATIONAL SAFETY AND HEALTH SERIES No. 22 (Rev. 2011); 2011.
9. Organization WH. Guidelines for controlling and monitoring the tobacco epidemic: World Health Organization; 1998.
10. Egashira R, Tanaka T, Imaizumi T, Senda K, Doki Y, Kudo S, et al. Differential distribution of lymphatic clearance between upper and lower regions of the lung. Respirology. 2013;18(2):348-53.
11. Asgharian B, Hofmann W, Bergmann R. Particle deposition in a multiple-path model of the human lung. Aerosol Science & Technology. 2001;34(4):332-9.
12. Subramaniam RP, Asgharian B, Freijer JI, Miller FJ, Anjilvel S. Analysis of lobar differences in particle deposition in the human lung. Inhalation toxicology. 2003;15(1):1-21.
13. Halldin CN, Blackley DJ, Markle T, Cohen RA, Laney AS. Patterns of progressive massive fibrosis on modern coal miner chest radiographs. Archives of environmental & occupational health. 2020;75(3):152-8.
14. Ferreira ÁS, Moreira VB, Ricardo HMV, Coutinho R, Gabetto JM, Marchiori E. Progressive massive fibrosis in silica-exposed workers: high-resolution computed tomography findings. Jornal Brasileiro de Pneumologia. 2006;32(6):523-8.
15. Ng TP, Chan SL. Factors associated with massive fibrosis in silicosis. Thorax. 1991;46(4):229-32.
16. Almberg KS, Halldin CN, Blackley DJ, Laney AS, Storey E, Rose CS, et al. Progressive massive fibrosis resurgence identified in US coal miners filing for black lung benefits, 1970–2016. Annals of the American Thoracic Society. 2018;15(12):1420-6.
17. Nin CS, de Souza VVS, do Amaral RH, Neto RS, Alves GRT, Marchiori E, et al. Thoracic lymphadenopathy in benign diseases: A state of the art review. Respiratory medicine. 2016;112:10-7.
18. Satija B, Kumar S, Ojha UC, Gothi D. Spectrum of high-resolution computed tomography imaging in occupational lung disease. The Indian journal of radiology & imaging. 2013;23(4):287.
19. Seaton A, Cherrie JW. Quartz exposures and severe silicosis: a role for the hilar nodes. Occupational and environmental medicine. 1998;55(6):383-6.
20. Cox-Ganser JM, Burchfiel CM, Fekedulegn D, Andrew ME, Ducatman BS. Silicosis in lymph nodes: the canary in the miner? Journal of occupational and environmental medicine/American College of Occupational and Environmental Medicine. 2009;51(2):164.
21. Murray J, Webster I, Reid G, Kielkowski D. The relation between fibrosis of hilar lymph glands and the development of parenchymal silicosis. Occupational and Environmental Medicine. 1991;48(4):267-9.
22. Marchiori E, Hochhegger B, Zanetti G. Lymph node calcifications. Jornal Brasileiro de Pneumologia. 2018;44(2):83-.
23. Brown K, Mund DF, Aberle DR, Batra P, Young DA. Intrathoracic calcifications: radiographic features and differential diagnoses. Radiographics. 1994;14(6):1247-61.
24. Ooi C, Khong P, Cheng R, Tan B, Tsang F, Lee I, et al. The relationship between mediastinal lymph node attenuation with parenchymal lung parameters in silicosis. The International Journal of Tuberculosis and Lung Disease. 2003;7(12):1199-206.
25. Cox CW, Rose CS, Lynch DA. State of the art: imaging of occupational lung disease. Radiology. 2014;270(3):681-96.
26. Corbett EL, Churchyard GJ, Clayton T, Herselman P, Williams B, Hayes R, et al. Risk factors for pulmonary mycobacterial disease in South African gold miners: a case-control study. American journal of respiratory and critical care medicine. 1999;159(1):94-9.
27. Barboza CEG, Winter DH, Seiscento M, Santos UdP, Terra Filho M. Tuberculosis and silicosis: epidemiology, diagnosis and chemoprophylaxis. Jornal Brasileiro de Pneumologia. 2008;34(11):959-66.
28. Cowie RL. The epidemiology of tuberculosis in gold miners with silicosis. American journal of respiratory and critical care medicine. 1994;150(5):1460-2.
29. Ferreira A, Moreira V, Souza A, Gabetto J, Clemente C, Aidé M. Silicotuberculose: análise de 82 casos. J Pneumol. 2000;26(S3):43-4.
30. Algranti E. Slateworkers’ pneumoconiosis: MSc thesis. University of Wales; 1982.
31. Al-Kassimi FA. Pleural effusion in silicosis of the lung. British journal of industrial medicine. 1992;49(6):448.
32. Mazziotti S, Costa C, Ascenti G, Lamberto S, Scribano E. Unusual pleural involvement after exposure to amorphous silicates (Liparitosis): report of two cases. European radiology. 2002;12(5):1058-60.
33. Xeren EH, Colby TV, Roggli VL. Silica-induced pleural disease: an unusual case mimicking malignant mesothelioma. Chest. 1997;112(5):1436-8.
34. Arakawa H, Honma K, Saito Y, Shida H, Morikubo H, Suganuma N, et al. Pleural disease in silicosis: pleural thickening, effusion, and invagination. Radiology. 2005;236(2):685-93.
35. Lopes AJ, Mogami R, Capone D, Tessarollo B, Melo PLd, Jansen JM. High-resolution computed tomography in silicosis: correlation with chest radiography and pulmonary function tests. Jornal Brasileiro de Pneumologia. 2008;34(5):264-72.
36. Ooi GC, Tsang KW, Cheung TF, Khong PL, Ho IW, Ip MS, et al. Silicosis in 76 men: qualitative and quantitative CT evaluation—clinical-radiologic correlation study. Radiology. 2003;228(3):816-25.
37. Bégin R, Ostiguy G, Cantin A, Bergeron D. Lung function in silica-exposed workers: a relationship to disease severity assessed by CT scan. Chest. 1988;94(3):539-45.
38. Arakawa H, Gevenois PA, Saito Y, Shida H, De Maertelaer V, Morikubo H, et al. Silicosis: expiratory thin-section CT assessment of airway obstruction. Radiology. 2005;236(3):1059-66.
39. Gross P, de Treville RT. Black lungs. Taylor & Francis; 1970.
40. Morgan WKC, Burgess DB, Jacobson G, O’Brien RJ, Pendergrass EP, Reger RB, et al. The prevalence of coal workers’ pneumoconiosis in US coal miners. Archives of Environmental Health: An International Journal. 1973;27(4):221-6.
41. Hsieh Y, Wang D, Shen C, Chiang C. The diffusing capacity blood gases analysis and ventilatory functions in coal workers' pneumoconiosis. Chin Med J. 1981;28:103-16.
42. Rasmussen D, Nelson C. Respiratory function in southern Appalachian coal miners. American Review of Respiratory Disease. 1971;103(2):240-8.
43. Yeoh C-I, Yang S-C. Pulmonary function impairment in pneumoconiotic patients with progressive massive fibrosis. Chang Gung medical journal. 2002;25(2):72-80.
44. de Castro MCS, Ferreira AS, Irion KL, Hochhegger B, Lopes AJ, Velarde GC, et al. CT quantification of large opacities and emphysema in silicosis: correlations among clinical, functional, and radiological parameters. Lung. 2014;192(4):543-51.
45. Lyons J, Ryder R, Seal R, Wagner J. Emphysema in smoking and non-smoking coalworkers with pneumoconiosis. Bulletin europeen de physiopathologie respiratoire. 1981;17(1):75-85.