Upper lobe-dominant pulmonary fibrosis showing deposits of hard metal component in the fibrotic lesions.

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.

• Authors: Yoshiko Kaneko, Norihiro Kikuchi, Yukio Ishii, Yoshinori Kawabata, Hiroshi Moriyama, Masaki Terada, Eiichi Suzuki, Masayoshi Kobayashi, Kouichi Watanabe, Nobuyuki Hizawa
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 49 Issue 19 Pg. 2143-5 ( 2010) ISSN: 1349-7235 [Electronic] Japan
• PMID: 20930444 (Publication Type: Case Reports, Journal Article)

Chemical References

• Alloys
• hard metal
• Cobalt
• Tungsten

Topics

• Alloys (analysis, pharmacokinetics, toxicity)
• Cobalt (analysis, pharmacokinetics, toxicity)
• Diagnosis, Differential
• Electron Probe Microanalysis
• Humans
• Male
• Middle Aged
• Occupational Diseases (diagnostic imaging, etiology, metabolism, pathology)
• Occupational Exposure
• Pulmonary Fibrosis (diagnostic imaging, etiology, metabolism, pathology)
• Radiography, Thoracic
• Tomography, X-Ray Computed
• Tungsten (analysis, pharmacokinetics, toxicity)