Silicosis differential diagnosis: Difference between revisions
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{{Silicosis}} | {{Silicosis}} | ||
==Overview== | ==Overview== | ||
*Silicosis must be differentiated from other diseases | * Silicosis must be differentiated from other diseases that cause pulmonary fibrosis and pulmonary nodules on imaging, such as[[asbestosis]],[[coal workers pneumoconiosis]], mycobacterial, fungal, and parasitic infections[[infections]], and pulmonary malignancy. | ||
=== | == Differential Diagnosis == | ||
=== | === Other pneumoconiosis === | ||
*Both [[ | * The distinction between silicosis and other occupational disease (such as asbestosis or berylliosis) is made based on history of occupational exposure. | ||
* Both[[Coal workers' pneumoconiosis|coal workers pneumoconiosis]]<nowiki/>and[[silicosis]]<nowiki/>may result in the development of pulmonary nodules (diameter range from 1 to 10 cm) that are typically located in the upper pulmonary lobes . | |||
* [[Beryllium|Beryllium-associated lung disease]]<nowiki/>can present with multiple pulmonary nodules and mimic the radiologic appearance of[[sarcoidosis]]. | |||
* [[Caplan’s disease]]<nowiki/>is a combination of[[rheumatoid arthritis]]<nowiki/>and[[Coal workers' pneumoconiosis|coal-worker’s pneumoconiosis]]<nowiki/>that manifests with multiple pulmonary nodules.<ref name="pmid14103053"></ref> | |||
=== | === Malignant diseases === | ||
*Multiple pulmonary nodules | * Multiple pulmonary nodules that are ≥1 cm in diameter are likely to be metastatic disease from a malignant solid organ primary tumor.<ref name="pmid105406723"></ref><ref name="pmid38616293"></ref> | ||
* Multiple pulmonary nodules that are <5 mm in diameter, juxtaposed to either the visceral pleura or an interlobar fissure, and detected incidentally, are more likely to be benign lesions, such as[[granulomata]],[[scars]], or[[intraparenchymal lymph nodes]].<ref name="pmid201771053"></ref> | |||
===Parasites=== | === Mycobacterial infections === | ||
*Humans acquire the [[paragonimus westermani]] infection by ingesting uncooked fresh water crabs or crayfish that harbor the metacercarial stage of the parasite. [[Paragonimus westermani]] is a fluke that is endemic in parts of [[China]], [[Korea]], [[Japan]], the [[Philippines]], and [[Taiwan]]. | * Both tuberculosis and atypical mycobacterial infections can result in the development of multiple nodules, which exceed 5 mm in diameter. Overall, multiple nodules caused by mycobacterial infections are relatively rare in comparison to the other characteristic imaging manifestations of[[tuberculosis]]<nowiki/>and atypical mycobacterial infections.<ref name="pmid193494063"></ref> | ||
=== Fungi === | |||
* Multiple pulmonary nodules may be due to a fungal infection, namely[[histoplasmosis]],[[coccidioidomycosis]],[[blastomycosis]], or[[cryptococcosis]]. | |||
* Invasive aspergillosis is more common among[[immunocompromised hosts]]. | |||
* Nodules due to fungal infection tend to be 0.5 to 3 cm in diameter and do not have a predilection for a specific region of the lungs. Fungal nodules usually demonstrate either[[cavitation]]<nowiki/>or[[calcification]].<ref name="pmid102104833"></ref><ref name="pmid86687683"></ref> | |||
=== Parasites === | |||
* Humans acquire the[[paragonimus westermani]]<nowiki/>infection by ingesting either uncooked fresh water crabs or crayfish that harbor the metacercarial stage of the parasite. | |||
* [[Paragonimus westermani]]<nowiki/>is a fluke that is endemic in parts of[[China]],[[Korea]],[[Japan]], the[[Philippines]], and[[Taiwan]]. | |||
* The typical radiographic appearance of Paragonimus is the development of multiple cavities with surrounding foci of consolidation, which may represent[[hemorrhage]], most commonly located in the lower and middle lung zones. CT may also demonstrate either linear adjacent to the nodules, suggestive of parasitic burrowing tracts.<ref name="pmid209830833"></ref> | |||
==References== | ==References== | ||
Revision as of 14:35, 30 June 2015
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Overview
- Silicosis must be differentiated from other diseases that cause pulmonary fibrosis and pulmonary nodules on imaging, such asasbestosis,coal workers pneumoconiosis, mycobacterial, fungal, and parasitic infectionsinfections, and pulmonary malignancy.
Differential Diagnosis
Other pneumoconiosis
- The distinction between silicosis and other occupational disease (such as asbestosis or berylliosis) is made based on history of occupational exposure.
- Bothcoal workers pneumoconiosisandsilicosismay result in the development of pulmonary nodules (diameter range from 1 to 10 cm) that are typically located in the upper pulmonary lobes .
- Beryllium-associated lung diseasecan present with multiple pulmonary nodules and mimic the radiologic appearance ofsarcoidosis.
- Caplan’s diseaseis a combination ofrheumatoid arthritisandcoal-worker’s pneumoconiosisthat manifests with multiple pulmonary nodules.[1]
Malignant diseases
- Multiple pulmonary nodules that are ≥1 cm in diameter are likely to be metastatic disease from a malignant solid organ primary tumor.[2][3]
- Multiple pulmonary nodules that are <5 mm in diameter, juxtaposed to either the visceral pleura or an interlobar fissure, and detected incidentally, are more likely to be benign lesions, such asgranulomata,scars, orintraparenchymal lymph nodes.[4]
Mycobacterial infections
- Both tuberculosis and atypical mycobacterial infections can result in the development of multiple nodules, which exceed 5 mm in diameter. Overall, multiple nodules caused by mycobacterial infections are relatively rare in comparison to the other characteristic imaging manifestations oftuberculosisand atypical mycobacterial infections.[5]
Fungi
- Multiple pulmonary nodules may be due to a fungal infection, namelyhistoplasmosis,coccidioidomycosis,blastomycosis, orcryptococcosis.
- Invasive aspergillosis is more common amongimmunocompromised hosts.
- Nodules due to fungal infection tend to be 0.5 to 3 cm in diameter and do not have a predilection for a specific region of the lungs. Fungal nodules usually demonstrate eithercavitationorcalcification.[6][7]
Parasites
- Humans acquire theparagonimus westermaniinfection by ingesting either uncooked fresh water crabs or crayfish that harbor the metacercarial stage of the parasite.
- Paragonimus westermaniis a fluke that is endemic in parts ofChina,Korea,Japan, thePhilippines, andTaiwan.
- The typical radiographic appearance of Paragonimus is the development of multiple cavities with surrounding foci of consolidation, which may representhemorrhage, most commonly located in the lower and middle lung zones. CT may also demonstrate either linear adjacent to the nodules, suggestive of parasitic burrowing tracts.[8]