Alexandre Franco Amaral1, Anna
Faibischew Prado1, Mario
Terra-Filho1 and Ubiratan de
1Pulmonary Division, Heart
Institute (InCor), Hospital das Cl?nicas da Faculdade de
Medicina da Universidade de S?o Paulo, S?o Paulo,
Silicosis is a common condition worldwide, and its diagnosis relies
upon a thorough occupational history. Nevertheless, there are
situations in which images are critical for the diagnosis, such as
pulmonary masses, due to lung cancer and tuberculosis risks.
To report cases of misleading diagnosis in patients with pulmonary
masses and occupational exposure to silica.
reviewed data on patients with a diagnosis of silicosis in a tertiary
hospital, who presented with pulmonary masses and were either submitted
to unnecessary procedures, due to lack of information on occupational
exposition, or had to be further investigated because of atypical
presentations of the disease.
Two patients presented silicosis with compatible exposure and
radiological findings, but had pulmonary masses of unusual locations,
which turned out to be lung adenocarcinomas. Three other patients with
pulmonary masses and silicosis radiological findings had been submitted
to lung resections, including a pneumonectomy, due to the absence of an
occupational history. The remaining four had known exposure to silica
but, owing to lack of other typical findings of the disease on chest
CT, were submitted to biopsies (transthoracic), all of which turned out
to be silicosis, and evolved with typical radiological findings.
Silicosis is yet a frequent disease and it should be included in the
differential diagnosis of pulmonary masses. The importance of an
occupational history and the possibility of a differential diagnosis
must be taken into account while evaluating these patients. Pulmonary
medical training programs should be aware of this not so rare condition.