PDF(Pubmed)
Abstract：
Pneumoconiosis is an occupational disease found in workers with environmental exposure to organic and inorganic dust, as in mining, sandblasting, pottery, stone masonry, and farming. The inflammatory response of the lung to respirable dust causes the formation of macules, nodules, and fibrosis, and higher silica content in inhaled dust is associated with increased fibrosis. Mixed dust pneumoconiosis (MDP) is characterized by exposure to dust containing 10-20% silica, and its lung imaging show irregular opacities. Histopathology plays a vital role in the diagnosis of MDP. Though it has a favorable outcome, it evolves slowly over many years of constant exposure and is characterized by worsening dyspnea and cough gradually progressing to cor pulmonale. The only effective treatment is removing exposure, which makes it essential to recognize the disease early for a favorable outcome. We present a case of mixed dust pneumoconiosis in a farmer from South America who had asthma. He presented with worsening dyspnea and multiple nodules in both lungs on imaging and cor pulmonale. An extensive workup was done, and it ruled out any malignancy and tuberculosis. Analysis of video-assisted thoracoscopic surgery (VATS) biopsy samples confirmed the diagnosis of mixed dust pneumoconiosis. He had a confluence of irregular nodes in the upper lobes of the lungs, and the largest was 2.1 cm. This fits the International Labour Organization (ILO) definition of progressive massive fibrosis. This, along with cor pulmonale present in him, gives it a poor prognosis even after he is removed from dust exposure. He received steroids, which led to symptomatic improvement, and he was discharged to follow up with the pulmonologist.
摘要：
尘肺是在环境中暴露于有机和无机粉尘的工人中发现的一种职业病，就像在采矿中一样，喷砂,陶器,砌石,和农业。肺部对可吸入粉尘的炎症反应导致斑疹的形成，结节,和纤维化，吸入粉尘中二氧化硅含量较高与纤维化增加有关。混合粉尘尘肺（MDP）的特征是暴露于含有10-20％二氧化硅的粉尘中，肺部成像显示不规则混浊。组织病理学在MDP的诊断中起着至关重要的作用。虽然结果很好,它在多年的持续暴露中缓慢发展，其特征是呼吸困难和咳嗽逐渐恶化为肺心病。唯一有效的治疗方法是消除暴露，这使得早期识别疾病对于有利的结果至关重要。我们介绍了一名南美农民患有哮喘的混合性尘肺病例。他在影像学和肺心病上表现为呼吸困难恶化和双肺多发结节。进行了广泛的检查，排除了任何恶性肿瘤和肺结核.分析电视胸腔镜手术（VATS）活检标本证实诊断为混合性尘肺。他在肺的上叶有不规则的结节汇合，最大为2.1厘米。这符合国际劳工组织(ILO)对进行性大规模纤维化的定义。这个,随着肺心病出现在他身上，即使在他远离灰尘暴露后，也会给它一个不好的预后。他接受了类固醇,导致症状改善，他已经出院去追踪肺科医生.
