Imaging of Occupational Lung Disease1
Kun-Il Kim, MD,
Chang Won Kim, MD,
Min Ki Lee, MD,
Kyung Soo Lee, MD,
Choong-Ki Park, MD,
Seok Jin Choi, MD and
Jong Gi Kim, MD
1 From the Departments of Diagnostic Radiology (K.I.K., C.W.K., J.G.K.) and Internal Medicine (M.K.L.), Pusan National University Hospital, Pusan National University School of Medicine, #1-10, Ami-dong, Seo-gu, Pusan 602-739, Korea; the Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (K.S.L.); the Department of Diagnostic Radiology, Hanyang University Kuri Hospital, Kyoungki-Do, Korea (C.K.P.); and the Department of Radiology, Pusan Paik Hospital, College of Medicine, Inje University, Pusan, Korea (S.J.C.). Recipient of a Cum Laude award for an education exhibit at the 2000 RSNA scientific assembly. Received April 11, 2001; revision requested May 15 and received July 17; accepted July 17. Address correspondence to K.I.K. (e-mail: kikim@hyowon.pusan.ac.kr).
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Figure 1a. Simple silicosis in a 59-year-old man who worked in hard-rock mining for 10 years. (a) Chest radiograph shows diffuse nodular opacities with relative sparing of the basal lung zones. (b) High-resolution CT scan shows numerous micronodules in both upper lungs with posterior zonal predominance. Nodules are more profuse in the right upper lung zone than in the left. Some nodules are centrilobular in location (arrows). Note also the multiple subpleural nodules and the "pseudoplaques," which represent the aggregate of subpleural nodules.
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Figure 1b. Simple silicosis in a 59-year-old man who worked in hard-rock mining for 10 years. (a) Chest radiograph shows diffuse nodular opacities with relative sparing of the basal lung zones. (b) High-resolution CT scan shows numerous micronodules in both upper lungs with posterior zonal predominance. Nodules are more profuse in the right upper lung zone than in the left. Some nodules are centrilobular in location (arrows). Note also the multiple subpleural nodules and the "pseudoplaques," which represent the aggregate of subpleural nodules.
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Figure 2. CWP in a 48-year-old man. High-resolution CT scan shows numerous small nodules that are less well defined than those seen in silicosis.
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Figure 3a. Complicated CWP in a 57-year-old man. (a) Chest radiograph shows a conglomeration of small nodules with sparing of the bibasilar area and egg-shell calcifications in both hila. (b) High-resolution CT scan shows conglomerate masses (progressive massive fibrosis) and adjacent small nodules. A thoracostomy tube (arrowhead) was placed in the left hemithorax for a pneumothorax.
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Figure 3b. Complicated CWP in a 57-year-old man. (a) Chest radiograph shows a conglomeration of small nodules with sparing of the bibasilar area and egg-shell calcifications in both hila. (b) High-resolution CT scan shows conglomerate masses (progressive massive fibrosis) and adjacent small nodules. A thoracostomy tube (arrowhead) was placed in the left hemithorax for a pneumothorax.
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Figure 4. Calcified progressive massive fibrosis in a 60-year-old retired coal worker. High-resolution CT scan (mediastinal windowing) shows a densely calcified right parahilar mass.
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Figure 5. Complicated silicosis in a 58-year-old man. High-resolution CT scan shows a cavitary conglomerate mass in the left upper lobe. Note the paracicatricial emphysema between the pleura and the cavitary mass (arrowhead). Although pulmonary tuberculosis may complicate silicosis or CWP, progressive massive fibrosis sometimes demonstrates cavitation due to ischemic necrosis.
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Figure 6. Silicoproteinosis in a 52-year-old quarry worker. Chest radiography showed bilateral ground-glass opacity and airspace consolidation, predominantly in the lower lung zones. High-resolution CT scan of the right lung shows patchy areas of ground-glass attenuation with fine intralobular reticulation ("crazy paving" pattern) (arrowheads), findings that are common in alveolar proteinosis. No silicotic nodules are seen. Bronchoalveolar lavage and transbronchial lung biopsy confirmed the presence of alveolar proteinosis and silica particles.
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Figure 7. Arc welder pneumoconiosis in a 46-year-old nonsmoker with a 15-year history of employment as a shipyard welder. High-resolution CT scan shows numerous small nodules and branching areas of hyperattenuation that are poorly defined and centrilobular. The diagnosis of siderosis was proved at transbronchial lung biopsy.
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Figure 8. Arc welder pneumoconiosis in a 57-year-old former smoker with a 13-year history of work in shipyards. The patient was asymptomatic, and the results of pulmonary function tests were normal. High-resolution CT scan shows ground-glass attenuation that is diffuse and mainly centrilobular. Follow-up high-resolution CT performed 1 year later showed no change in the parenchymal disease.
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Figure 9a. Carbon pneumoconiosis in a 49-year-old man with a 10-year history of employment in a carbon black factory. (a) Chest radiograph shows a fine reticulonodular pattern with lower zonal predominance. (b) High-resolution CT scan shows diffuse areas of ground-glass attenuation and numerous small centrilobular nodules.
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Figure 9b. Carbon pneumoconiosis in a 49-year-old man with a 10-year history of employment in a carbon black factory. (a) Chest radiograph shows a fine reticulonodular pattern with lower zonal predominance. (b) High-resolution CT scan shows diffuse areas of ground-glass attenuation and numerous small centrilobular nodules.
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Figure 10a. Giant cell interstitial pneumonia in a 52-year-old man. (a) Chest radiograph shows patchy areas of ground-glass opacity and fine reticulation in both lower lung zones. (b) High-resolution CT scan obtained at the level of the lung base shows bilateral areas with small cysts, ground-glass attenuation, fine reticular hyperattenuation, and traction bronchiectasis, findings that indicate fibrosis. Video-assisted thoracoscopic surgical biopsy revealed giant cell interstitial pneumonia.
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Figure 10b. Giant cell interstitial pneumonia in a 52-year-old man. (a) Chest radiograph shows patchy areas of ground-glass opacity and fine reticulation in both lower lung zones. (b) High-resolution CT scan obtained at the level of the lung base shows bilateral areas with small cysts, ground-glass attenuation, fine reticular hyperattenuation, and traction bronchiectasis, findings that indicate fibrosis. Video-assisted thoracoscopic surgical biopsy revealed giant cell interstitial pneumonia.
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Figure 11. Giant cell interstitial pneumonia in a 45-year-old worker in a saw manufacturing plant. High-resolution CT scan shows patchy areas of ground-glass attenuation and fine linear hyperattenuating areas predominantly involving the lower lung zones. The diagnosis of hard metal pneumoconiosis was proved with occupational history and video-assisted thoracoscopic surgical biopsy.
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Figure 12a. Pleural plaques, diffuse pleural thickening, rounded atelectasis, and asbestosis in a 50-year-old man with asbestos exposure from working in a brake lining production plant. (a) Chest radiograph shows diffuse thickening of the left pleura and curvilinear band opacities in the left lower lung zone. (b) High-resolution CT scan (mediastinal windowing) shows pleural plaques on the right side (small white arrows) and rounded atelectasis (large white arrow) with adjacent diffuse pleural thickening (black arrows) on the left side. (c) High-resolution CT scan obtained at a lower level than b demonstrates pleural plaques along the diaphragmatic contour (black arrows) and an irregular attenuation pattern, which is typical in rounded atelectasis (white arrows). (d) High-resolution CT scan (lung windowing) obtained at the level of the liver dome shows a visceral pleural plaque in the right major fissure (arrow) and curvilinear bands of hyperattenuation in the posterior subpleural area. Note also the rounded atelectasis with posterior displacement of the left major fissure. The diagnosis of asbestosis was proved at open lung biopsy.
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Figure 12b. Pleural plaques, diffuse pleural thickening, rounded atelectasis, and asbestosis in a 50-year-old man with asbestos exposure from working in a brake lining production plant. (a) Chest radiograph shows diffuse thickening of the left pleura and curvilinear band opacities in the left lower lung zone. (b) High-resolution CT scan (mediastinal windowing) shows pleural plaques on the right side (small white arrows) and rounded atelectasis (large white arrow) with adjacent diffuse pleural thickening (black arrows) on the left side. (c) High-resolution CT scan obtained at a lower level than b demonstrates pleural plaques along the diaphragmatic contour (black arrows) and an irregular attenuation pattern, which is typical in rounded atelectasis (white arrows). (d) High-resolution CT scan (lung windowing) obtained at the level of the liver dome shows a visceral pleural plaque in the right major fissure (arrow) and curvilinear bands of hyperattenuation in the posterior subpleural area. Note also the rounded atelectasis with posterior displacement of the left major fissure. The diagnosis of asbestosis was proved at open lung biopsy.
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Figure 12c. Pleural plaques, diffuse pleural thickening, rounded atelectasis, and asbestosis in a 50-year-old man with asbestos exposure from working in a brake lining production plant. (a) Chest radiograph shows diffuse thickening of the left pleura and curvilinear band opacities in the left lower lung zone. (b) High-resolution CT scan (mediastinal windowing) shows pleural plaques on the right side (small white arrows) and rounded atelectasis (large white arrow) with adjacent diffuse pleural thickening (black arrows) on the left side. (c) High-resolution CT scan obtained at a lower level than b demonstrates pleural plaques along the diaphragmatic contour (black arrows) and an irregular attenuation pattern, which is typical in rounded atelectasis (white arrows). (d) High-resolution CT scan (lung windowing) obtained at the level of the liver dome shows a visceral pleural plaque in the right major fissure (arrow) and curvilinear bands of hyperattenuation in the posterior subpleural area. Note also the rounded atelectasis with posterior displacement of the left major fissure. The diagnosis of asbestosis was proved at open lung biopsy.
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Figure 12d. Pleural plaques, diffuse pleural thickening, rounded atelectasis, and asbestosis in a 50-year-old man with asbestos exposure from working in a brake lining production plant. (a) Chest radiograph shows diffuse thickening of the left pleura and curvilinear band opacities in the left lower lung zone. (b) High-resolution CT scan (mediastinal windowing) shows pleural plaques on the right side (small white arrows) and rounded atelectasis (large white arrow) with adjacent diffuse pleural thickening (black arrows) on the left side. (c) High-resolution CT scan obtained at a lower level than b demonstrates pleural plaques along the diaphragmatic contour (black arrows) and an irregular attenuation pattern, which is typical in rounded atelectasis (white arrows). (d) High-resolution CT scan (lung windowing) obtained at the level of the liver dome shows a visceral pleural plaque in the right major fissure (arrow) and curvilinear bands of hyperattenuation in the posterior subpleural area. Note also the rounded atelectasis with posterior displacement of the left major fissure. The diagnosis of asbestosis was proved at open lung biopsy.
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Figure 13. Calcified pleural plaques in a 63-year-old man. CT scan shows calcified pleural plaques (arrows), which are a hallmark of asbestos exposure.
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Figure 14. Asbestosis in a 62-year-old man. Prone high-resolution CT scan shows bilateral subpleural reticular hyperattenuating areas, small cysts, traction bronchiectasis, and areas of ground-glass attenuation. A small left diaphragmatic hernia is incidentally noted. Video-assisted thoracoscopic surgical biopsy revealed asbestosis and discrete pleural plaques.
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Figure 15a. Malignant mesothelioma in a 51-year-old man. (a) Chest radiograph shows irregular nodular pleural thickening in the right hemithorax. (b) Intravenous contrast-enhanced CT scan helps confirm an irregular thick rind along the right pleural surface. (c) CT scan shows tumor invasion of the abdomen (arrow).
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Figure 15b. Malignant mesothelioma in a 51-year-old man. (a) Chest radiograph shows irregular nodular pleural thickening in the right hemithorax. (b) Intravenous contrast-enhanced CT scan helps confirm an irregular thick rind along the right pleural surface. (c) CT scan shows tumor invasion of the abdomen (arrow).
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Figure 15c. Malignant mesothelioma in a 51-year-old man. (a) Chest radiograph shows irregular nodular pleural thickening in the right hemithorax. (b) Intravenous contrast-enhanced CT scan helps confirm an irregular thick rind along the right pleural surface. (c) CT scan shows tumor invasion of the abdomen (arrow).
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Figure 16. Malignant mesothelioma in a 66-year-old man. Intravenously administered contrast material-enhanced CT scan shows a focally enhancing pleura-based mass invading the chest wall with destruction of the adjacent ribs (black arrow). Note the calcified plaque in the paravertebral area (white arrow).
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Figure 17a. Paraquat poisoning in a 43-year-old farmer. The patient had taken a mouthful of paraquat and spat it out in a drunken state. (a) Chest radiograph obtained 3 days after the accident shows a large right pneumothorax, pneumomediastinum (arrows), and diffuse haziness in the left lung. (b) High-resolution CT scan obtained following thoracostomy shows ground-glass attenuation throughout both lungs, a right pneumothorax, interstitial pulmonary emphysema (arrowheads), and pneumomediastinum (arrow).
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Figure 17b. Paraquat poisoning in a 43-year-old farmer. The patient had taken a mouthful of paraquat and spat it out in a drunken state. (a) Chest radiograph obtained 3 days after the accident shows a large right pneumothorax, pneumomediastinum (arrows), and diffuse haziness in the left lung. (b) High-resolution CT scan obtained following thoracostomy shows ground-glass attenuation throughout both lungs, a right pneumothorax, interstitial pulmonary emphysema (arrowheads), and pneumomediastinum (arrow).
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Figure 18a. Paraquat poisoning in a 19-year-old man. Initial chest radiography showed peripheral areas of consolidation and ground-glass opacity in both lungs. (a) Follow-up chest radiograph obtained on the 30th day of hospitalization shows diffuse reticular opacities in both lungs with decreased lung volume. Note the pneumomediastinum and subcutaneous emphysema. (b) Initial high-resolution CT scan shows areas of ground-glass attenuation and consolidation predominantly involving the peripheral lungs. (c) High-resolution CT scan obtained on the 39th day of hospitalization shows reticular hyperattenuating areas, small cysts, and traction bronchiectasis corresponding to the affected areas in b, indicating progression to interstitial fibrosis. (Fig 18a-c courtesy of Mi Jeong Shin, MD, Wallace Memorial Baptist Hospital, Pusan, Korea.)
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Figure 18b. Paraquat poisoning in a 19-year-old man. Initial chest radiography showed peripheral areas of consolidation and ground-glass opacity in both lungs. (a) Follow-up chest radiograph obtained on the 30th day of hospitalization shows diffuse reticular opacities in both lungs with decreased lung volume. Note the pneumomediastinum and subcutaneous emphysema. (b) Initial high-resolution CT scan shows areas of ground-glass attenuation and consolidation predominantly involving the peripheral lungs. (c) High-resolution CT scan obtained on the 39th day of hospitalization shows reticular hyperattenuating areas, small cysts, and traction bronchiectasis corresponding to the affected areas in b, indicating progression to interstitial fibrosis. (Fig 18a-c courtesy of Mi Jeong Shin, MD, Wallace Memorial Baptist Hospital, Pusan, Korea.)
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Figure 18c. Paraquat poisoning in a 19-year-old man. Initial chest radiography showed peripheral areas of consolidation and ground-glass opacity in both lungs. (a) Follow-up chest radiograph obtained on the 30th day of hospitalization shows diffuse reticular opacities in both lungs with decreased lung volume. Note the pneumomediastinum and subcutaneous emphysema. (b) Initial high-resolution CT scan shows areas of ground-glass attenuation and consolidation predominantly involving the peripheral lungs. (c) High-resolution CT scan obtained on the 39th day of hospitalization shows reticular hyperattenuating areas, small cysts, and traction bronchiectasis corresponding to the affected areas in b, indicating progression to interstitial fibrosis. (Fig 18a-c courtesy of Mi Jeong Shin, MD, Wallace Memorial Baptist Hospital, Pusan, Korea.)
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Figure 19a. Hydrogen sulfide gas poisoning in a 45-year-old man who was found unconscious in a storage tank of salted radish in rice bran (Danmuji). A major component of the gas examined at chromatography was hydrogen sulfide. (a) Chest radiograph shows diffuse bilateral opacities. (b) Thin-section CT scan shows areas of airspace consolidation and ground-glass attenuation in the dependent portion of both lungs. Follow-up chest radiography performed 1 month later demonstrated resolution of the parenchymal infiltrates.
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Figure 19b. Hydrogen sulfide gas poisoning in a 45-year-old man who was found unconscious in a storage tank of salted radish in rice bran (Danmuji). A major component of the gas examined at chromatography was hydrogen sulfide. (a) Chest radiograph shows diffuse bilateral opacities. (b) Thin-section CT scan shows areas of airspace consolidation and ground-glass attenuation in the dependent portion of both lungs. Follow-up chest radiography performed 1 month later demonstrated resolution of the parenchymal infiltrates.
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Figure 20. Bronchiolitis obliterans due to ammonia inhalation in a 56-year-old woman who had survived the explosion of an industrial refrigerator 15 years earlier. The patient was treated at that time with mechanical ventilation due to prolonged pulmonary injury. Chest radiography showed overinflation of both lungs with diffuse bronchiectasis in both lower lung zones. High-resolution CT scan shows bronchiectasis and areas of hypoattenuation with hyperattenuating vessels throughout both lungs.
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Figure 21a. Hydrocarbon pneumonitis in a 54-year-old man who accidentally aspirated liquid petroleum while repairing an obstructed pipe. The patient presented with fever, dyspnea, and hemoptysis 1 day after aspiration. (a) Chest radiograph shows airspace consolidation in both lower lung zones. (b) High-resolution CT scan obtained on the 2nd day of hospitalization shows areas of ground-glass attenuation and areas of patchy or nodular consolidation (arrows) in both lower lung zones. (c) CT scan (mediastinal windowing) shows hypoattenuating areas of consolidation, a finding that suggests necrosis. Bloody secretions were obtained at bronchoscopy. Transbronchial lung biopsy and bronchoalveolar lavage showed necrotic tissue with degenerated inflammatory cells and many red blood cells.
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Figure 21b. Hydrocarbon pneumonitis in a 54-year-old man who accidentally aspirated liquid petroleum while repairing an obstructed pipe. The patient presented with fever, dyspnea, and hemoptysis 1 day after aspiration. (a) Chest radiograph shows airspace consolidation in both lower lung zones. (b) High-resolution CT scan obtained on the 2nd day of hospitalization shows areas of ground-glass attenuation and areas of patchy or nodular consolidation (arrows) in both lower lung zones. (c) CT scan (mediastinal windowing) shows hypoattenuating areas of consolidation, a finding that suggests necrosis. Bloody secretions were obtained at bronchoscopy. Transbronchial lung biopsy and bronchoalveolar lavage showed necrotic tissue with degenerated inflammatory cells and many red blood cells.
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Figure 21c. Hydrocarbon pneumonitis in a 54-year-old man who accidentally aspirated liquid petroleum while repairing an obstructed pipe. The patient presented with fever, dyspnea, and hemoptysis 1 day after aspiration. (a) Chest radiograph shows airspace consolidation in both lower lung zones. (b) High-resolution CT scan obtained on the 2nd day of hospitalization shows areas of ground-glass attenuation and areas of patchy or nodular consolidation (arrows) in both lower lung zones. (c) CT scan (mediastinal windowing) shows hypoattenuating areas of consolidation, a finding that suggests necrosis. Bloody secretions were obtained at bronchoscopy. Transbronchial lung biopsy and bronchoalveolar lavage showed necrotic tissue with degenerated inflammatory cells and many red blood cells.
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Figure 22. Mercury vapor poisoning in a 34-year-old woman who had worked for a mercury thermometer manufacturer for 30 months. The patient presented with headache and dyspnea and suffered from chronic gingivitis. Mercury levels in the blood and urine were markedly elevated. Pulmonary function tests revealed a mixed pattern of obstructive and restrictive defects. Chest radiography showed perivascular haziness and fine reticular opacities in the parahilar area of both lungs. Thin-section CT scan shows areas of ground-glass attenuation, poorly defined centrilobular nodules (arrows), and bronchial wall thickening. Note the relative sparing of the periphery of both lungs.
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Figure 23a. Multidrug-resistant pulmonary tuberculosis in a medical resident. The disease was acquired during two synchronous outbreaks in a tertiary hospital. Two residents required surgical resection of a lung or lobe. (a) High-resolution CT scan obtained during treatment with antituberculous medication shows cavitary tuberculosis in the left upper lobe. Follow-up chest radiography revealed aggravation of the disease with involvement of the left lower lobe. Left pneumonectomy was performed 1 year after initiation of medication. (b) Follow-up high-resolution CT scan obtained 3 months after surgery demonstrates a new tuberculous lesion in the apical segment of the right upper lobe.
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Figure 23b. Multidrug-resistant pulmonary tuberculosis in a medical resident. The disease was acquired during two synchronous outbreaks in a tertiary hospital. Two residents required surgical resection of a lung or lobe. (a) High-resolution CT scan obtained during treatment with antituberculous medication shows cavitary tuberculosis in the left upper lobe. Follow-up chest radiography revealed aggravation of the disease with involvement of the left lower lobe. Left pneumonectomy was performed 1 year after initiation of medication. (b) Follow-up high-resolution CT scan obtained 3 months after surgery demonstrates a new tuberculous lesion in the apical segment of the right upper lobe.
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Figure 24a. Leptospirosis and pulmonary hemorrhage in a 63-year-old farmer. (a) Initial chest radiograph shows fine reticulonodular opacities throughout both lungs. (b) High-resolution CT scan obtained the same day shows ground-glass attenuation, intralobular interstitial thickening, and ill-defined small nodular hyperattenuating areas.
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Figure 24b. Leptospirosis and pulmonary hemorrhage in a 63-year-old farmer. (a) Initial chest radiograph shows fine reticulonodular opacities throughout both lungs. (b) High-resolution CT scan obtained the same day shows ground-glass attenuation, intralobular interstitial thickening, and ill-defined small nodular hyperattenuating areas.
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Figure 25a. Isocyanate-induced acute hypersensitivity pneumonitis in a 36-year-old man who presented with severe cough and dyspnea after spray painting in a ship repair plant. (a) Chest radiograph shows patchy airspace consolidation throughout both lungs. A predominantly peripheral area of consolidation is seen in the right lung. (b) High-resolution CT scan obtained on the 2nd day of hospitalization shows patchy areas of consolidation and ground-glass attenuation in both lungs and less profuse small nodular hyperattenuating areas. Note the pneumomediastinum, which is probably associated with the severe cough. Follow-up high-resolution CT performed 9 days later showed complete resolution of the parenchymal hyperattenuating areas.
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Figure 25b. Isocyanate-induced acute hypersensitivity pneumonitis in a 36-year-old man who presented with severe cough and dyspnea after spray painting in a ship repair plant. (a) Chest radiograph shows patchy airspace consolidation throughout both lungs. A predominantly peripheral area of consolidation is seen in the right lung. (b) High-resolution CT scan obtained on the 2nd day of hospitalization shows patchy areas of consolidation and ground-glass attenuation in both lungs and less profuse small nodular hyperattenuating areas. Note the pneumomediastinum, which is probably associated with the severe cough. Follow-up high-resolution CT performed 9 days later showed complete resolution of the parenchymal hyperattenuating areas.
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Figure 26. Isocyanate-induced subacute hypersensitivity pneumonitis in a 36-year-old man who had been working as a painter for an interior decorating company. High-resolution CT scan shows patchy areas of ground-glass attenuation and small, predominantly centrilobular nodular hyperattenuating areas throughout both lungs.
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Figure 27a. Byssinosis in a 56-year-old woman who had had frequent episodes of "Monday fever" and dyspnea while working in a cotton quilt factory over a 7-year period. (a) Chest radiograph shows diffuse, ill-defined haziness, predominantly in the lower lung zones. (b) High-resolution CT scan shows numerous ill-defined small nodules with ground-glass attenuation in both lungs. (c) High-resolution CT scan obtained 23 days later shows resolution of the ground-glass attenuation with fewer residual small nodules than were previously noted. No abnormality was seen at high-resolution CT performed 1 year after the patient quit her job. In spite of prolonged exposure, the patient’s respiratory symptoms and pulmonary functional impairment resolved completely.
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Figure 27b. Byssinosis in a 56-year-old woman who had had frequent episodes of "Monday fever" and dyspnea while working in a cotton quilt factory over a 7-year period. (a) Chest radiograph shows diffuse, ill-defined haziness, predominantly in the lower lung zones. (b) High-resolution CT scan shows numerous ill-defined small nodules with ground-glass attenuation in both lungs. (c) High-resolution CT scan obtained 23 days later shows resolution of the ground-glass attenuation with fewer residual small nodules than were previously noted. No abnormality was seen at high-resolution CT performed 1 year after the patient quit her job. In spite of prolonged exposure, the patient’s respiratory symptoms and pulmonary functional impairment resolved completely.
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Figure 27c. Byssinosis in a 56-year-old woman who had had frequent episodes of "Monday fever" and dyspnea while working in a cotton quilt factory over a 7-year period. (a) Chest radiograph shows diffuse, ill-defined haziness, predominantly in the lower lung zones. (b) High-resolution CT scan shows numerous ill-defined small nodules with ground-glass attenuation in both lungs. (c) High-resolution CT scan obtained 23 days later shows resolution of the ground-glass attenuation with fewer residual small nodules than were previously noted. No abnormality was seen at high-resolution CT performed 1 year after the patient quit her job. In spite of prolonged exposure, the patient’s respiratory symptoms and pulmonary functional impairment resolved completely.
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Copyright © 2001 by the Radiological Society of North America.
