CTICasesSilicosis with Progressive Massive Fibrosis
Imaging findings
Chest radiography and CT demonstrate symmetric, upper lung-predominant micronodules and large, conglomerate soft-tissue masses with surrounding architectural distortion, classic for progressive massive fibrosis (PMF). There is also prominent mediastinal and bilateral hilar lymphadenopathy with peripheral or eggshell-like calcifications.
Key takeaways
Nuclear site and energy workers, who are routinely screened for occupational asbestos exposure, may also have histories of exposure to other minerals, such as silica dust from mining or rock-crushing. This exposure can lead to classic silicosis with progressive massive fibrosis (PMF), which can radiographically mimic sarcoidosis, berylliosis, or talc inhalation. Distinguishing silicosis from asbestosis is critical, as silicosis typically presents with upper lung-predominant nodularity and PMF, unlike the subpleural, lower lung-predominant interstitial fibrosis seen in asbestosis.
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