CTICasesHard Metal Pneumoconiosis
Imaging findings
Chest CT in a 41-year-old male dental technician demonstrates a spatially homogeneous interstitial lung disease characterized by diffuse ground-glass opacities, reticulation, and non-subpleural microcystic changes that involve all lung zones, with a slight lower-lobe predominance. Surgical lung biopsy shows classic giant cell interstitial pneumonia (GIP) with cannibalistic multinucleated giant cells in the alveolar spaces.
Key takeaways
Hard metal pneumoconiosis (or giant cell interstitial pneumonia [GIP]) is an occupational lung disease caused by the inhalation of heavy metal dusts, specifically cobalt and tungsten. Dental technicians who polish metals are at high risk if adequate ventilation and personal protective equipment are not used. Unlike IPF/UIP, GIP shows a highly spatially homogeneous distribution of ground-glass and fibrosis on CT.
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