Is Pneumoconiosis due to Coal Exposure, Organized Pneumonia or Hypersensitivity Reaction? An Interesting Case!

Introduction: Kaolinite, illite, calcite, pyrite and quartz (silica) in coal dust. Coal worker’s pneumoconiosis is the most common occupational disease in Turkey. It is an interstitial lung disease that can result in pulmonary fibrosis. Therefore, interstitial changes that are detected radiologically in coal mine workers are considered as coal worker pneumoconiosis. We wanted to share the findings of an interesting patient in a coal mine worker.
 

Case Presentation: A 53-year-old male patient had complaints of dyspnea, chest pain, sweating, malaise and cough for 15-20 days. 30 pack/year smokers and 20 years working in a coal mine. Thorax bt and x-ray showed bilateral widespread ground glass and consolidation areas. In the bronchoalveolar lavage, a large number of macrophages and most of these macrophages contained pigment. Transbronchail biopsy; Multifocal anthracosis areas in interstitium, protrused fibroblastic proliferation foci of alveolar lumen in several areas, lung parenchyma characterized by mild focal interstitial fibroinflammatory thickening. The findings were evaluated nonspecific. The patient left the job and the radiology of the patient recovered almost completely in the control radiograph and thorax bt after 3 months. The patient did not receive any treatment during this time.
 

Conclusion: The patient definitely states that there is no change in his life except for leaving the work. We thought this was a possible hypersensitivity reaction. We observed that he recovered from exposure.