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Study Syllabus for Classification of Radiographs of Pneumoconioses
Clinical Overview
Central Role of Diagnostic Imaging
Table 1: Radiologic patterns of lung disease associated with occupational exposures on chest radiograph and chest CT.
| Pattern | Common occupational diseases or exposures | Differential diagnosis |
|---|---|---|
| Small rounded opacities | Coal worker’s pneumoconiosis Silicosis Other pneumoconiosis (talcosis, stannosis, etc.) Chronic beryllium disease |
Sarcoidosis Chronic mycobacterial or fungal infection |
| Large opacities | Coal worker’s pneumoconiosis Silicosis Chronic beryllium disease |
Sarcoidosis, malignancy (if unilateral) Chronic mycobacterial or fungal infection |
| Small irregular opacities (reticular) | Asbestosis Coal worker’s pneumoconiosis Silicosis Chronic hypersensitivity pneumonitis |
Idiopathic interstitial pneumonias (nonspecific interstitial pneumonia, usual interstitial pneumonia) Collagen vascular disease Smoking-related lung disease |
| Ground-glass opacity | Hypersensitivity pneumonitis Acute or subacute inhalational lung injury Hard metal pneumoconiosis Chronic beryllium disease |
Smoking-related lung disease Drug toxicity Pulmonary hemorrhage Aspiration |
| Consolidation | Acute or accelerated silicosis Acute or subacute lung injury |
Infection Pulmonary hemorrhage Malignancy Organizing pneumonia Aspiration |
| Bronchial wall thickening | Acute or subacute toxic fume Inhalation Occupational bronchitis Occupational asthma |
Bronchitis Asthma |
| Emphysema | Silicosis Coal worker’s pneumoconiosis Hypersensitivity pneumonitis |
Smoking-related lung disease Alpha-1 antitrypsin deficiency |
| Mosaic attenuation/air trapping | Bronchiolitis from toxic fume or chemical inhalation (eg, flavoring chemicals) | Obliterative bronchiolitis related to collagen vascular disease, previous infection, etc. |
| Pleural thickening/plaques | Asbestosis | Infection, trauma, neoplasm |