52 year-old male presents to clinic for worsening dyspnea. The patient’s history is significant for working as a miner for the past 20 years.
The fibrotic changes of the upper lungs and patient’s history make complicated silicosis the most likely diagnosis. Chronic silicosis exposure can manifest in a variety of imagine appearances from diffuse nodularity (simple disease) to massive fibrosis (complicated disease) as seen in this case. Calcification of the affected lung parenchyma and adjacent mediastinal lymph nodes is also a common occurrence.