Progressive massive fibrosis

Simple CWP often occurs concomitantly with chronic bronchitis and emphysema. Although CWP is associated with several respiratory impairments, it is not associated with shortened life span the importance of this benign condition is the fact that it is a precursor of progressive massive fibrosis (PMF). However, simple CWP does not progress in the absence of further exposure. 

Chronic bronchitis, pneumoconiosis, obstructive lung disease, focal emphysema, progressive massive fibrosis (PMF), coal workers pneumoconiosis (CWP), siUcosis Acute bronchospasm, pneumonitis, chronic exposure leads to Itmg fibrosis, progressive massive fibrosis (PMF), coal workers pneumoconiosis (CWP), silicosis Ocular and upper airway irritation, bronchospasm in severe exposure, contact dermatitis... 

Coal dust, coal fly ash Dusts generated by coal mining, processing, and combustion activities. Inhalation. Black lung — includes CWP, progressive massive fibrosis, chronic airway obstruction or bronchitis, emphysema possible silicosis due to intermixed crystalline silica. 

Ebihara and Kawami (1990) in 140 consecutive necropsies of silicotics found 25 with carcinoma, i.e. 19.9%. The predominant type was squamous cell carcinoma (54.2 %) followed by small-cell carcinoma (22.9%) and adenocarcinoma (14.6%). In cases of progressive massive fibrosis the majority of tumours arose in the segmental bronchi leading to the fibrotic masses. The majority of peripheral lung tumours were closely adjacent to fibrotic areas. 

In 460 autopsied coal miners from West Virginia on pathologic examination 96 % had macules, 70 % micronodules, 45% macronodules, 15% silicosis, and 28% progressive massive fibrosis (Vallya-THAN et al. 1996). 

Fig. 26.23. Silicosis with progressive massive fibrosis in a 72-year-old man. Coronal CT image shows a large mass in the right medial upper lobe (arrowhead). There is retraction of the hilus and marked emphysema In addition, some scattered small nodules are present...

Crystalline silica Dusts generated by mining, other industrial activities. Dusts produced by erosion of friable, silica-rich rocks (i.e., some ash flow tuffs, diatomaceous earth deposits). Inhalation. Silicosis, industrial bronchitis with airflow limitation, progressive massive fibrosis. Associated illnesses include opportunistic infections, sihca nethropathy, lung cancer. 

Progressive Massive Fibrosis PMF or complicated CWP typically appears on a background of severe simple CWP. PMF lesions are most commonly... 

Fig. 2.1.8. Gough (1-mm paper) section of a lung from a worked with complicated coal worker s pneumoconiosis (progressive massive fibrosis). The arrows show two large lesions. The lesion in the apex has partially cavitated...

Progressive massive fibrosis Diffuse interstitial fibrosis Pleural fibrosis... 

Fig.5.10a,b. A 68-year-old retired construction site worker, a Thin-section CT scan through the upper lobes shows bilateral progressive massive fibrosis (PMF) with surrounding paracicatricial emphysema, b Thin-section CT scan through the lower lobes shows confluent centrilobular emphysema (asterisks) in the right lower lobes and bullae in the left lower lobe (arrows)... 

O Connell M, Kennedy M (2004) Progressive massive fibrosis secondary to pulmonary silicosis appearance on F-18 fluorodeoxyglucose PET/CT. Clin Nucl Med 29 754-755... 

Seal RME, Cockcroft A, Kung I et al (1986) Central lymph node changes and progressive massive fibrosis in coalworkers. Thorax 41 531-537... 

CWP can be divided into a simple form with multiple small rounded pulmonary nodules and a complicated form with large masses, also called progressive massive fibrosis (PMF). The complication occurs in about 30% of patients who have diffuse bilateral small opacities and may develop after exposure to coal dust has ceased and may progress in the absence of further exposure (Morgan 1984). 

Fig. 6.4. Coal worker s pneumoconiosis postero-anterior chest radiograph showing progressive massive fibrosis that produces shrinkage of adjacent lung with hyperexpansion of the lower lobes...

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