Silicosis and Lung Cancer
Symptoms and Diagnosis
Symptoms of Silicosis
· chronic dry cough
· shortness of breath with exercise, usually in patients who have progressive massive fibrosis.
Additional symptoms that may be associated with this disease, especially in acute silicosis:
· fever
· cough
· weight loss / loss of appetite
· severe breathing difficulty
· trouble sleeping
· chest pain
· nails with a bluish tint
Diagnosis
Diagnosis of silicosis is based on:
· A detailed occupational history to determine if there has been occupational exposure.
· Chest x rays will usually show small round opaque areas in chronic silicosis; the round areas are larger in complicated and accelerated silicosis. (see X ray)
· Bronchoscopy, a procedure that involves placing a flexible tube with a camera at the end down the nose or throat to visualize, and often take tissue specimens of the lungs. This is rarely needed. (See photo of lung slice)
· Pulmonary Function Test, a lung function tests done by blowing into a tube which then measures how much air is in the lungs and how forcefully this air can be exhaled. Individuals with silicosis have a diminished lung capacity.
It should be noted that the severity of the patient's symptoms does not always correlate with x-ray findings or lung function test results.
Silicosis looks like this through and X rays and under a microscope.
Silicosis X rays:
 Silicosis, Fig. 1
Chest radiograph showing multiple small nodules predominantly in the upper and middle zones.
 Silicosis, Fig. 2
Chest radiograph of a patient with progressive massive fibrosis. Note the masses surrounded by emphysematous lung.
Silicosis under a microscope:
The below photo shows a slice of lung from a 61-year-old ceramics worker. It shows diffuse pleural fibrosis (upper right), which involves interlobar fissures; and multiple, hard, black silicotic nodules (arrow marks one), which are confluent in the anterior upper lobe and upper portion of the lower lobe.
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