Pneumoconioses

Feature	Asbestosis	Coal Worker’s	Silicosis	Berylliosis
Exposure	Shipbuilding, roofing, pipes	Coal mining	Sandblasting, rock mining	Aerospace, electronics
Lung Zone	Lower Lobes	Upper Lobes	Upper Lobes	Upper Lobes
CXR Buzzword	Pleural plaques	Nodular opacities	Eggshell calcification	Hilar adenopathy
Pathology	Asbestos bodies	Anthracosis	Fibrotic nodules	Non-caseating granulomas
High-Yield Association	Mesothelioma, Bronchogenic CA	Caplan Syndrome (rheumatoid arthritis and pneumoconiotic nodules)	↑↑ Risk of Tuberculosis	Mimics Sarcoidosis

Mnemonic

• Asbestos is from the roof (was common in insulation), but affects the base (lower lobes).
• Silica, coal, and berries are from the base (earth), but affect the roof (upper lobes).

Mnemonics

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“Silly Sandy rocks! She builds tunnels”

Silicosis: 

• Sanblasting

• Rock mining

• Tunneling

原始发布： achingtentacles

“Beto insults that ship’s pipes”

Asbestosis

• Insulators

• Shipyard workers

• Pipe fitting

原始发布： banditnarwhal

“Busy cotton”

Byssinosis:

• Cotton

原始发布： mabohstarbuck

“Very electronic”

Berylliosis:

• Electronic manufacture

原始发布： bullet-proof-love-ptv

“Sugar makes me vaga” (vaga is Spanish for lazy)

Bagassosis:

• Moldy sugar cane

原始发布： yoitskojo

Pathophysiology

Classifications

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Asbestosis

• Etiology: Airborne asbestos fibers
• Population at risk:
  • Asbestos miners and millers
  • Brake linings and insulation manufactures
  • Ship construction workers
  • Demolishers
• Clinical features:
  • Symptoms typically develop 15–20 years after initial exposure.
  • Exertional dyspnea
  • Dry cough that transforms into productive cough
  • Digital clubbing
  • Ferruginous bodies in alveolar septa on histology
  • Complications
    • Lung cancer (smoking increases the risk):bronchogenic carcinoma is most common
    • Mesothelioma: rarely occurs without a history of asbestos exposure
• Chest x-ray:
  • Diffuse bilateral infiltrates predominantly in the lower lobes
  • Interstitial fibrosis
  • Calcified pleural plaques (usually indicate benign pleural disease)
• Microscopic
  • 

  This is the causative agent for asbestosis, a long, thin asbestos fiber. Some houses, business locations, and ships still contain building products with asbestos, particularly insulation materials, so care must be taken when doing remodelling or reconstruction.

Silicosis

• Etiology
  • Inhalation of crystalline silica, most commonly as dust
  • High-risk occupations for the development of silicosis include sandblasting, mining, and working in foundries

Mnemonic

The silly egg sandwich I found is mine!

• Clinical features
  • Chronic cough (often with sputum) and exertional dyspnea
  • Caplan syndrome: pneumoconiosis in combination with rheumatoid arthritis; characterized by rapid development of basilar nodules and mild obstruction of ventilation
• Chest x-ray
  • Eggshell calcification: well-defined sickle-shaped calcification of the rims of hilar lymph nodes
  • Bilateral diffuse ground glass opacities
  • Large number of rounded, solitary, small (≤ 1 cm in diameter) opacities particularly in the upper lobe of the lungs
• Biopsy: silicotic nodules, characterized by weakly birefringent silica particles in a central hyalinized region surrounded by concentric “onion-skin” collagen fibers
• Etiology:
• Population at risk:
• Clinical features:
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• Etiology:
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Clinical features

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Diagnostics

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Treatment

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