[Pulmonary sarcoidlike granulomatosis induced by aluminum dust: a case report and literature review].

OBJECTIVE

To highlight the etiological diagnosis of pulmonary granulomatosis.

METHODS

The clinical, radiological and pathological data of a patient with sarcoidlike lung granulomatosis confirmed by open lung biopsy were presented, and relevant literatures were reviewed.

RESULTS

A 50-year-old female worker presented with intermittent cough and dyspnea for 3 years, after exposure to aluminum dust for 15 years. Radiographs of the chest and high-resolution CT demonstrated bilateral areas of ground-glass attenuation, patchy areas of consolidation, extensive reticular hyper-attenuating areas and traction bronchiectasis. Lung function studies showed a restrictive pattern with a low diffusion capacity. Lung biopsy specimens confirmed the presence of diffuse, noncaseating granulomatous nodules. Scanning electron microscopy and energy-dispersive radiograph analysis revealed large quantities of foreign particles mainly containing aluminum in granulomas. Her cough, dyspnea, radiological shadowing and pulmonary function showed marked improvement after corticosteroid therapy.

CONCLUSIONS

With the occupational history, histological and mineralogical studies, the patient was considered to have pulmonary sarcoidlike granulomatosis, most likely related to occupational exposure to aluminum dust. The search for any possible relevant exposure of a patient with suspected sarcoidosis seems mandatory.