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Radiography and CT of Occupational and Environmental Lung Diseases

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A Clinical Guide to Occupational and Environmental Lung Diseases

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Abstract

This chapter addresses the imaging of the more common pneumoconioses and hypersensitivity pneumonitis and offers a brief description of the International Labour Office (ILO) International Classification of Radiographs of Pneumonoconioses. The imaging abnormalities of this group of diseases vary depending on the nature of the lung insult, but generally include homogeneous, hazy, ground-glass opacities as well as heterogeneous opacities including small irregular linear and nodular opacities. End-stage fibrosis may be manifested by volume loss, traction bronchiectasis, and honeycomb lung. Asbestosis usually involves the lower lobes and produces small irregular opacities that are frequently seen in conjunction with pleura plaques. Silicosis usually involves the upper lobes and is characterized by small nodules which may eventually grow and coalesce into large opacities or progressive massive fibrosis with distorted lung and emphysema. Talcosis may resemble either asbestosis or silicosis. Berylliosis tends to mimic the appearance of sarcoidosis which in turn, at times, resembles silicosis. Coal worker’s pneumoconiosis similarly mimics silicosis. Hard metal exposure produces images with ground-glass and irregular linear opacities as well as centrilobular nodules and emphysema. Hypersensitivity pneumonitis appears as scattered ground-glass and centrilobular opacities, air trapping, and, in late stages, pulmonary fibrosis with predominant upper lobe involvement. A description of the ILO classification of pneumoconioses and a brief description of the B-reading process including history, object, uses, and future direction are also included in this chapter.

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Goodman, P.C. (2012). Radiography and CT of Occupational and Environmental Lung Diseases. In: Huang, YC., Ghio, A., Maier, L. (eds) A Clinical Guide to Occupational and Environmental Lung Diseases. Respiratory Medicine. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-149-3_4

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