CTICasesCoal Worker's Pneumoconiosis
Imaging findings
Chest radiography reveals diffuse, discrete, small, round nodules measuring approximately 1.5 to 3 millimeters (ILO classification q and r sizes) with a distinct upper-zone predominance. Hilar lymph node enlargement and thickening of the right paratracheal stripe are also visible. There is evidence of early nodular coalescence in the right upper zone, suggestive of a developing large opacity.
Key takeaways
Coal worker's pneumoconiosis (CWP) typically presents as small, discrete nodules in the upper lungs of patients with long-standing occupational exposure (typically over 20 years). Coalescence of these nodules into lesions larger than 1 centimeter signifies progression to progressive massive fibrosis (PMF). Distinguishing early coalescence from PMF is a frequent challenge during B-reading.
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