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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Silicosis Related Diseases

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