Abstract
We present a 54-year-old man employed in the field of hard metal manufacturing who complained of progressive dyspnea and weight loss. His chest radiograph showed bilateral fibrosis predominantly distributed in the upper lobes with bilateral pleural effusions, and a strong reduction in lung volume. Lung histopathology showed apical cap-like fibrosis but no giant cell interstitial pneumonia. Electron probe microanalysis detected tungsten deposits in the fibrotic region: we therefore considered this to be a case of hard metal disease. Hard metal disease should be considered as one possibility in the differential diagnosis of upper lobe-dominant pulmonary fibrosis.
MeSH terms
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Alloys / analysis
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Alloys / pharmacokinetics*
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Alloys / toxicity*
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Cobalt / analysis
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Cobalt / pharmacokinetics*
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Cobalt / toxicity*
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Diagnosis, Differential
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Electron Probe Microanalysis
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Humans
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Male
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Middle Aged
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Occupational Diseases / diagnostic imaging
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Occupational Diseases / etiology
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Occupational Diseases / metabolism*
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Occupational Diseases / pathology*
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Occupational Exposure
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Pulmonary Fibrosis / diagnostic imaging
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Pulmonary Fibrosis / etiology
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Pulmonary Fibrosis / metabolism*
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Pulmonary Fibrosis / pathology*
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Radiography, Thoracic
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Tomography, X-Ray Computed
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Tungsten / analysis
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Tungsten / pharmacokinetics*
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Tungsten / toxicity*
Substances
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Alloys
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hard metal
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Cobalt
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Tungsten