Uncommon pneumoconioses: CT and pathologic findings.

PURPOSE: To correlate the computed tomographic (CT) features of pneumoconioses with histologic findings.

MATERIALS AND

METHODS

Thin-section CT scans obtained in 48 patients with a history of occupational exposure to dust and radiographic changes suggestive of pneumoconiosis were retrospectively reviewed. Histologic samples were available in 22 cases.

RESULTS

The most common CT features were as follows: in 21 arc welders, ill-defined micronodules concentrated in the centrilobular regions (n = 15); in 19 graphite workers, small nodular hyperattenuating areas (n = 17) (ill defined or well defined, corresponding to macular lesions along the walls of bronchioles and nodules, respectively), interlobular septal thickening (n = 11), and large hyperattenuating areas (n = 10); in aluminum pneumoconiosis, predominant reticular (n = 2), nodular (n = 2), and upper-lobe fibrosis (n = 2); and in hard-metal pneumoconiosis, multilobular ground-glass attenuation and consolidation with shrinkage (corresponding to marked intra-alveolar desquamation and multinucleated giant cells with mural mononuclear cell infiltrate).

CONCLUSION

Predominant findings are characteristic in each type of pneumoconiosis and are depicted at thin-section CT.