Abstract
Hard metal lung disease is usually easy to diagnose, on the basis of occupational history, chest X-ray appearance of interstitial lung disease and, if necessary, by bronchoalveolar lavage (BAL). However, other interstitial lung diseases may affect patients with an occupational history of exposure to cobalt. In hard metal disease, the hylar lymphnodes may enlarge due to high draining of hard metals from the lung tissue via lymphatic vessels. Also, the presence of Giant Cells (even if Langhan's type) in the BAL fluid of sarcoid patients may be high. We present four patients with a history of exposure to hard metals and whose chest X-rays suggest sarcoidosis, stage II; in each, a pulmonary biopsy was necessary to confirm the diagnosis. Final diagnosis was sarcoidosis in one (showing typical granulomata in the lung tissue), and hard metal disease in three: two of these had foreign body-type granulomata in the lung tissue. Neutron activation analysis (NAA) study was carried out on these four patients using specimens of BAL fluid, blood, urine, toenails, pubic hair and sperm. In the light of available data, the concentration of elements may not be useful in differentiating between sarcoidosis and hard metal pneumoconiosis. However, NAA on BAL fluid or other specimens may be helpful in confirming the presence of the offending agent in suspected cases when the occupational history is not clear.
| Original language | English |
|---|---|
| Pages (from-to) | 77-83 |
| Number of pages | 7 |
| Journal | Science of the Total Environment |
| Volume | 150 |
| Issue number | 1-3 |
| DOIs | |
| Publication status | Published - Jun 30 1994 |
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Keywords
- Cobalt
- Differential diagnosis
- Hard metal
- Neutron activation analysis
- Nuclear reactor
- Pneumoconiosis
- Sarcoidosis
- Tantalum
- Titanium
- Tungsten carbide
ASJC Scopus subject areas
- Environmental Science(all)
- Environmental Chemistry
Cite this
The differential diagnosis of hard metal lung disease. / Rizzato, Gianfranco; Fraioli, Patrizia; Sabbioni, Enrico; Pietra, Romano; Barberis, Massimo.
In: Science of the Total Environment, Vol. 150, No. 1-3, 30.06.1994, p. 77-83.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The differential diagnosis of hard metal lung disease
AU - Rizzato, Gianfranco
AU - Fraioli, Patrizia
AU - Sabbioni, Enrico
AU - Pietra, Romano
AU - Barberis, Massimo
PY - 1994/6/30
Y1 - 1994/6/30
N2 - Hard metal lung disease is usually easy to diagnose, on the basis of occupational history, chest X-ray appearance of interstitial lung disease and, if necessary, by bronchoalveolar lavage (BAL). However, other interstitial lung diseases may affect patients with an occupational history of exposure to cobalt. In hard metal disease, the hylar lymphnodes may enlarge due to high draining of hard metals from the lung tissue via lymphatic vessels. Also, the presence of Giant Cells (even if Langhan's type) in the BAL fluid of sarcoid patients may be high. We present four patients with a history of exposure to hard metals and whose chest X-rays suggest sarcoidosis, stage II; in each, a pulmonary biopsy was necessary to confirm the diagnosis. Final diagnosis was sarcoidosis in one (showing typical granulomata in the lung tissue), and hard metal disease in three: two of these had foreign body-type granulomata in the lung tissue. Neutron activation analysis (NAA) study was carried out on these four patients using specimens of BAL fluid, blood, urine, toenails, pubic hair and sperm. In the light of available data, the concentration of elements may not be useful in differentiating between sarcoidosis and hard metal pneumoconiosis. However, NAA on BAL fluid or other specimens may be helpful in confirming the presence of the offending agent in suspected cases when the occupational history is not clear.
AB - Hard metal lung disease is usually easy to diagnose, on the basis of occupational history, chest X-ray appearance of interstitial lung disease and, if necessary, by bronchoalveolar lavage (BAL). However, other interstitial lung diseases may affect patients with an occupational history of exposure to cobalt. In hard metal disease, the hylar lymphnodes may enlarge due to high draining of hard metals from the lung tissue via lymphatic vessels. Also, the presence of Giant Cells (even if Langhan's type) in the BAL fluid of sarcoid patients may be high. We present four patients with a history of exposure to hard metals and whose chest X-rays suggest sarcoidosis, stage II; in each, a pulmonary biopsy was necessary to confirm the diagnosis. Final diagnosis was sarcoidosis in one (showing typical granulomata in the lung tissue), and hard metal disease in three: two of these had foreign body-type granulomata in the lung tissue. Neutron activation analysis (NAA) study was carried out on these four patients using specimens of BAL fluid, blood, urine, toenails, pubic hair and sperm. In the light of available data, the concentration of elements may not be useful in differentiating between sarcoidosis and hard metal pneumoconiosis. However, NAA on BAL fluid or other specimens may be helpful in confirming the presence of the offending agent in suspected cases when the occupational history is not clear.
KW - Cobalt
KW - Differential diagnosis
KW - Hard metal
KW - Neutron activation analysis
KW - Nuclear reactor
KW - Pneumoconiosis
KW - Sarcoidosis
KW - Tantalum
KW - Titanium
KW - Tungsten carbide
UR - http://www.scopus.com/inward/record.url?scp=0028285195&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0028285195&partnerID=8YFLogxK
U2 - 10.1016/0048-9697(94)90132-5
DO - 10.1016/0048-9697(94)90132-5
M3 - Article
C2 - 7939613
AN - SCOPUS:0028285195
VL - 150
SP - 77
EP - 83
JO - Science of the Total Environment
JF - Science of the Total Environment
SN - 0048-9697
IS - 1-3
ER -