Pneumoconiosis differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dushka Riaz, MD

Overview

Pneumoconiosis must be differentiated from other diseases that cause chronic cough and dyspnea.

Differentiating Pneumoconiosis from other Diseases

Pneumoconiosis must be differentiated from other diseases that cause cough and dyspnea.

Differentiating pneumoconiosis from other diseases on the basis of dyspnea and cough

On the basis of cough and chronic dyspnea, pneumoconiosis must be differentiated from lung malignancy, tuberculosis, emphysema, asthma, interstitial lung disease, pneumonia, and sarcoidosis. [1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13] [14] [15] [16] [17] [18] [19] [20] [21] [22]

Diseases Clinical manifestations Para-clinical findings Gold standard
Symptoms Physical examination
Lab Findings Imaging
Chronic Dyspnea Cough Fever Spirometry Auscultation Night Sweats CBC ABG Imaging
Pneumoconiosis + + + ↑ FEV1/FVC Wheezing, rhonchi, crackles + WBC O2, ↑CO2 Massive fibrosis, hilar adenopathy, reticular opacities, pleural plaques HRCT
Lung Malignancy + + - Vt, ↑RV Wheezing, crackles + Normal Normal Mass lesion, hilar lymphadenopathy Bronchoscopy
Tuberculosis + + + Restrictive, obstructive, or mixed Wheezing, rhonchi, crackles + WBC O2, ↑CO2 Patchy consolidation, nodular opacities IFN-y assay and acid fast stain
Emphysema + + - FEV1/FVC Wheezing - Normal Respiratory alkalosis, Metabolic acidosis Flat diaphragm Physical exam, spirometry
Asthma + + - FEV1/FVC Wheezing - ↑ Eosinophil Respiratory alkalosis, Metabolic acidosis Normal Physical exam, spirometry before and after bronchodilator
Interstitial lung diseases + + - FEV1/FVC Wheezing, rhonchi, crackles +/- Normal O2, ↑CO2 Peripheral pulmonary infiltrative opacification HRCT
Sarcoidosis + + - FEV1/FVC Crackles + Normal O2, ↑CO2 Hilar adenopathy HRCT
Pneumonia + + + Normal Wheezing, rhonchi, crackles + WBC, neutrophilia Normal Lobar consolidation CXR, CT Scan

References

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