Silicosis due to Denim Sandblasting in Young People: MDCT Findings.

Abstract

Occupational lung disease due to silica dust is one of the most common work-related injuries. In denim sandblasting, workers are exposed to silica that may cause immediate mortality, especially in young people. The aim of this study was to assess the multidetector computed tomography (MDCT) findings of silicosis in denim sandblasters and to better define the role of MDCT in the early detection of silicosis. The study included 12 consecutive male patients who were admitted to a pulmonary outpatient clinic between April 2009 and December 2009. All patients had been working as sandblasters for at least one year. All patients underwent chest CT examinations for suspected silicosis. Two radiologists independently assessed the images for the presence and distribution of airspace consolidation, ground-glass opacity, nodules, interlobular septal thickening, parenchymal bands, fibrosis, masses, traction bronchiectasis, honeycombing, lobular low-attenuation areas, emphysema, pleural effusion or thickening, and mediastinal or hilar adenopathy. MDCT detected parenchymal abnormalities in the lungs in eight (67%) of the twelve patients. The most common MDCT finding was ground glass opacity (58%). Other common findings were parencyhmal nodules and interlobular septal thickening, predominantly in the upper zones. Nodules were detected in six (50%) of the twelve patients. In four cases (67%), the nodules were numerous (>10), were predominantly smaller than 10 mm, and were centrilobular in distribution. In five (42%) of the 12 patients, interlobular septal thickening was detected. Only one (8%) patient presented with airspace consolidation; this was bilateral in the upper zones and associated with air bronchograms. In one (8%) patient there were several traction bronchiectases in the upper zones. None of the patients presented with pleural effusion, thickening, or honeycombing. Enlarged mediastinal nodes were identified in half of the patients, predominantly in the precarinal, paratracheal, and prevascular regions. No egg-shell calcification was detected. One (8%) patient presented with punctate calcification in the hilar region. Early detection of silicosis is important because it may cause immediate mortality, especially in young people. Enlarged mediastinal lymph nodes, centrilobular nodules, interlobular septal thickening, and patchy ground glass opacity may be early MDCT findings of silicosis. Thus, MDCT plays an important role in the early detection of silicosis in denim sandblasters.