CTICasesComplicated Silicosis with Progressive Massive Fibrosis (PMF)
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Imaging findings
Chest radiographs demonstrated extensive pulmonary parenchymal disease with large opacities in the parahilar regions and upper lobes, smaller nodular opacities, and upward retraction of the hila (traction phenomenon, Jonkhof's Peak sign). These findings indicated upper lobe volume loss and extensive fibrosis. CT confirmed widespread coalescent nodules forming large opacities consistent with progressive massive fibrosis (PMF), affecting both upper and lower lung zones, with relative sparing of the anterior right middle lobe and lingula.
Key takeaways
Severe, complicated silicosis, often leading to progressive massive fibrosis (PMF), is an occupational lung disease resulting from prolonged inhalation of silica dust. It typically manifests with extensive pulmonary fibrosis, characteristic large coalescent opacities, volume loss (often upper lobe predominant), and hilar retraction. The diagnosis is confirmed by occupational history.
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