UNCOMMON PNEUMOCONIOSES - CT AND PATHOLOGICAL FINDINGS

PURPOSE: To correlate the computed tomographic (CT) features of pneumoconioses with histologic findings. MATERIALS AND METHODS: Thin-section CT scans obtained in 48 patients with a history of occupational exposure to dust and radiographic changes suggestive of pneumoconiosis were retrospectively reviewed. Histologic samples were available in 22 cases. RESULTS: The most common CT features were as follows: in 21 are welders, ill-defined micronodules concentrated in the centrilobular regions (n = 15); in 19 graphite workers, small nodular hyperattenuating areas (n = 17) (ill defined or well defined, corresponding to macular lesions along the walls of bronchioles and nodules, respectively), interlobular septal thickening (n = 11), and large hyperattenuating areas (n = 10); in aluminum pneumoconiosis, predominant reticular (n = 2), nodular (n = 2); and upper-lobe fibrosis (n = 2); and in hard-metal pneumoconiosis, multilobular ground-glass attenuation and consolidation with shrinkage (corresponding to marked intra-alveolar desquamation and multinucleated giant cells with mural mononuclear cell infiltrate). CONCLUSION: Predominant findings are characteristic in each type of pneumoconiosis and are depicted at thin-section CT.