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| Journal of the New Zealand Medical Association,
09-May-2008, Vol 121 No 1273
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Silicosis due to denim sandblasting: multidetector CT
findings
Metin Akgun, Mecit Kantarci, Omer Araz, Elif Yilmazel Ucar,
Arzu Mirici
A 17-year-old man presented to hospital with dry cough and
pleuritic chest pain. For approximately 2 years he had worked in a textile
factory as a denim sandblaster using silica-containing sand to abrade denim
material. He was diagnosed with accelerated silicosis.
In such cases, chest X-rays (Figure 1a) and HRCT images are
widely used. We also used multidetector CT (MDCT) in this case to better reveal
the nodules and fibrotic lesions and their association with bronchovascular
structures and pleural surfaces (Figure 1b).
Although axial MDCT images were comparable with HRCT images,
the best image achieved with MDCT was a 3D volume-rendering image, in which
pleural tractions and abnormal surface of pleura was shown very well as well as
distortion of parenchyma (Figures 2a and 2b).
Figure 1(a) Chest X-ray and (b) a MDCT coronal
MIP (maximum intensity projection) image of the case show bilateral diffuse
reticulonodular densities and nodules, fibrotic lesions, and their association
with pleura and vascular structure, respectively.
 Figure 2. Pleural images that are achieved
after reconstruction of MDCT raw images belonging to (a) an elderly female (60
yrs) with pulmonary thromboembolism and (b) the young silicosis case (17 yrs).
Note the differences (regularity/irregularity) of pleural surfaces. Pleural
surface of the case with silicosis has a very irregular margin due to traction
of parenchymal fibrosis.
 DiscussionSilicosis—a debilitating, sometimes fatal, yet
preventable occupational lung disease—is caused by inhaling respirable
crystalline silica dust. Although silicosis is a well-known disease, it
continues to be reported in a new and sometimes unusual or unexpected
occupation.
Recently denim sandblasting has been reported as a new cause
of silicosis with fatal outcomes.1–3
As presented here, we conclude that MDCT may be more
advantageous to characterise parenchymal abnormalities (especially on pleural
surfaces) compared with previous techniques.
Author information: Metin
Akgun1, Mecit
Kantarci2, Omer
Araz1,
Elif Yilmazel Ucar1, Arzu Mirici3
Correspondence:
Dr Metin Akgun, Aziziye Arastirma Hastanesi,
Gogus Hastaliklari Anabilim Dali, 25070 Erzurum,
Turkey. Fax: +90 442 3166340; email: akgunm@gmail.com
References:
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