Mineralogical analysis in the differential diagnosis of silicosis and sarcoidosis : diagnostic applications in pulmonary pathology.

Silicosis and thoracic sarcoidosis are both diffuse interstitial lung diseases, one occupational and the other idiopathic. The clinical and pathological findings of these two conditions show strong similarities, which can make diagnosis difficult. The main objective of this study is to present the mineralogical analysis techniques that can be performed on lung samples to provide new insights for distinguishing silicosis from thoracic sarcoidosis. A systematic review of the literature was conducted using the PubMed and Web of Science databases. A systematic review of the literature was conducted using the PubMed and Web of Science databases. Twenty-six articles published between 1975 and 2024 were included in the final analysis. The review identified seven mineralogical analysis techniques. Scanning and transmission electron microscopy are the oldest techniques, applicable to lung samples following digestion or in situ preparation. Methods for automating these techniques are emerging. X-ray diffraction and ICP-AES are techniques usable only on samples following digestion preparation and provide quantitative information only in terms of atomic compounds. Micro-PIXE and LIBS are more sophisticated techniques enabling the visualization of the distribution of atoms (silicon, aluminum, etc.) within tissues. Mineralogical analysis techniques, particularly electron microscopy coupled with elemental analysis and LIBS, represent valuable adjuncts in pulmonary pathology for identifying inorganic particles and supporting the differential diagnosis between pneumoconiosis and sarcoidosis in diagnostically challenging cases.