CTICasesComplicated Silicosis with Progressive Massive Fibrosis in a Well Digger and Concrete Cutter
[...]. Complicated Silicosis with Progressive Massive Fibrosis in a Well Digger and Concrete Cutter. CTICases. Published October 1, 2026. https://cticases.com/c/eg3bg
Imaging findings
There is advanced silicosis with diffuse, poorly defined small nodules, rather than the sharp round nodules that make silicosis easy to recognize. Bilateral conglomerate masses with volume loss indicate progressive massive fibrosis, probably ILO large opacity category B or C.
Key takeaways
Silicosis does not always show crisp, well-defined nodules, and blurry nodules with conglomerate masses still fit. Take a full occupational history. This patient dug wells for 32 years and also cut concrete. Concrete cutting is the more likely source, but silicosis has been reported in well diggers, and fracking is another recognized source of silica exposure.
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