Silicosis

Key Features

• Extensive or prolonged inhalation of free silica

• Small, rounded opacities (silicotic nodules) throughout the lung

Clinical Findings

• Calcification of peripheral hilar lymph nodes ("eggshell" calcification) strongly suggests silicosis

• Incidence of pulmonary tuberculosis is increased in patients with silicosis

Diagnosis

• Simple silicosis is usually asymptomatic without effect on pulmonary function tests

• Complicated silicosis presents with large conglomerate densities in the upper lung; dyspnea with restrictive and obstructive changes on pulmonary function tests is common

Treatment

• All patients require a tuberculin skin test and current chest radiograph

• Patients with suspected old pulmonary tuberculosis should be treated with multidrug regimens