肺淋巴管平滑肌瘤病2例诊疗分析

目的：提高对肺淋巴管平滑肌瘤病（PLAM）的认识,减少误诊。方法：对2例PLAM的临床资料并结合文献进行分析。结果：PLAM为一种弥漫性肺间质疾病,临床表现呼吸困难、咯血、气胸、乳糜胸等,极易被误诊。胸部HRCT具有特征性改变,显示两侧对称弥漫性广泛囊状影。结论：对于年轻育龄期女性反复出现气胸、乳糜胸,胸部HRCT提示囊状改变,需考虑PLAM,预后差,无特效治疗。     

肺淋巴管肌瘤病的影像学分析

目的探讨肺淋巴管肌瘤病的影像学表现，提高诊断水平。方法回顾性分析7例经病理证实的肺淋巴管肌瘤病的胸部X线片、常规CT及高分辨CT（HRCT）表现。结果胸部X线片无特异性，1例胸部X线片无异常发现，1例表现为两肺弥漫性的网状和线条状阴影，小蜂窝状或多发小囊状影，3例表现为气胸，2例表现为右侧胸腔积液。无一例发现肺门或纵隔淋巴结肿大。常规CT扫描虽然发现直径较大的囊腔样病变，但囊壁显示不清，HRCT扫描病变显示清晰，表现为两肺从肺尖至肺底弥漫分布的囊状改变，均有薄壁，壁厚约1mm，边缘清楚，厚薄均匀。大部分囊腔直径〈20mm。结论肺淋巴管肌瘤病的HRCT表现具有特征性，HRCT对明确诊断以及预后判断具有非常重要的应用价值。     

尘肺胸部圆形小阴影的影像学分布特点

目的 探讨尘肺胸部圆形小阴影的影像学分布特点.方法 回顾性分析在2006年3月至2008年5月间确诊的尘肺56例(Ⅰ期7例、Ⅱ期13例、Ⅲ36例)和6例无尘肺者的影像学表现.结果 1例Ⅲ期尘肺患者在X线胸片和CT上未见明确的圆形小阴影,5例Ⅲ期尘肺患者仅在大阴影附近有少许稀疏分布的圆形小阴影和无尘肺(0期)的6例患者只在CT扫描上有弥漫性分布的p影,其余50例尘肺患者在X线胸片和CT上均有弥漫性分布的圆形小阴影.50例中,于上、中肺区分布较多23例及上肺区分布较多18例,占82%;X线胸片显示,圆形小阴影在中、下肺区分布较多7例.CT显示,圆形小阴影以上、中肺区较多3例,在上、中、下肺区呈均匀分布4例.X线胸片显示,2例Ⅲ期尘肺的圆形小阴影在上、中、下肺区均匀分布,而CT显示以中肺区较多.除1例Ⅰ期尘肺的圆形小阴影在肺的前、中后部均匀分布外,其余49例尘肺患者的圆形小阴影均在肺的后部分布较多.6例无尘肺(0期)和50例呈弥漫性圆形小阴影的尘肺患者的CT显示,结节呈小叶中心分布lO例(0期4例、Ⅰ期6例),呈淋巴管周围分布46例(0期2例、Ⅰ期1例、Ⅱ期13例、Ⅲ期30例).结论 圆形小阴影的分布特点有助于尘肺的诊断及鉴别诊断.     

尘肺胸部圆形小阴影的影像学分布特点

目的 探讨尘肺胸部圆形小阴影的影像学分布特点.方法 回顾性分析在2006年3月至2008年5月间确诊的尘肺56例(Ⅰ期7例、Ⅱ期13例、Ⅲ36例)和6例无尘肺者的影像学表现.结果 1例Ⅲ期尘肺患者在X线胸片和CT上未见明确的圆形小阴影,5例Ⅲ期尘肺患者仅在大阴影附近有少许稀疏分布的圆形小阴影和无尘肺(0期)的6例患者只在CT扫描上有弥漫性分布的p影,其余50例尘肺患者在X线胸片和CT上均有弥漫性分布的圆形小阴影.50例中,于上、中肺区分布较多23例及上肺区分布较多18例,占82%;X线胸片显示,圆形小阴影在中、下肺区分布较多7例.CT显示,圆形小阴影以上、中肺区较多3例,在上、中、下肺区呈均匀分布4例.X线胸片显示,2例Ⅲ期尘肺的圆形小阴影在上、中、下肺区均匀分布,而CT显示以中肺区较多.除1例Ⅰ期尘肺的圆形小阴影在肺的前、中后部均匀分布外,其余49例尘肺患者的圆形小阴影均在肺的后部分布较多.6例无尘肺(0期)和50例呈弥漫性圆形小阴影的尘肺患者的CT显示,结节呈小叶中心分布lO例(0期4例、Ⅰ期6例),呈淋巴管周围分布46例(0期2例、Ⅰ期1例、Ⅱ期13例、Ⅲ期30例).结论 圆形小阴影的分布特点有助于尘肺的诊断及鉴别诊断.     

尘肺胸部圆形小阴影的影像学分布特点

目的 探讨尘肺胸部圆形小阴影的影像学分布特点.方法 回顾性分析在2006年3月至2008年5月间确诊的尘肺56例(Ⅰ期7例、Ⅱ期13例、Ⅲ36例)和6例无尘肺者的影像学表现.结果 1例Ⅲ期尘肺患者在X线胸片和CT上未见明确的圆形小阴影,5例Ⅲ期尘肺患者仅在大阴影附近有少许稀疏分布的圆形小阴影和无尘肺(0期)的6例患者只在CT扫描上有弥漫性分布的p影,其余50例尘肺患者在X线胸片和CT上均有弥漫性分布的圆形小阴影.50例中,于上、中肺区分布较多23例及上肺区分布较多18例,占82%;X线胸片显示,圆形小阴影在中、下肺区分布较多7例.CT显示,圆形小阴影以上、中肺区较多3例,在上、中、下肺区呈均匀分布4例.X线胸片显示,2例Ⅲ期尘肺的圆形小阴影在上、中、下肺区均匀分布,而CT显示以中肺区较多.除1例Ⅰ期尘肺的圆形小阴影在肺的前、中后部均匀分布外,其余49例尘肺患者的圆形小阴影均在肺的后部分布较多.6例无尘肺(0期)和50例呈弥漫性圆形小阴影的尘肺患者的CT显示,结节呈小叶中心分布lO例(0期4例、Ⅰ期6例),呈淋巴管周围分布46例(0期2例、Ⅰ期1例、Ⅱ期13例、Ⅲ期30例).结论 圆形小阴影的分布特点有助于尘肺的诊断及鉴别诊断.     

尘肺胸部圆形小阴影的影像学分布特点

目的 探讨尘肺胸部圆形小阴影的影像学分布特点.方法 回顾性分析在2006年3月至2008年5月间确诊的尘肺56例(Ⅰ期7例、Ⅱ期13例、Ⅲ36例)和6例无尘肺者的影像学表现.结果 1例Ⅲ期尘肺患者在X线胸片和CT上未见明确的圆形小阴影,5例Ⅲ期尘肺患者仅在大阴影附近有少许稀疏分布的圆形小阴影和无尘肺(0期)的6例患者只在CT扫描上有弥漫性分布的p影,其余50例尘肺患者在X线胸片和CT上均有弥漫性分布的圆形小阴影.50例中,于上、中肺区分布较多23例及上肺区分布较多18例,占82%;X线胸片显示,圆形小阴影在中、下肺区分布较多7例.CT显示,圆形小阴影以上、中肺区较多3例,在上、中、下肺区呈均匀分布4例.X线胸片显示,2例Ⅲ期尘肺的圆形小阴影在上、中、下肺区均匀分布,而CT显示以中肺区较多.除1例Ⅰ期尘肺的圆形小阴影在肺的前、中后部均匀分布外,其余49例尘肺患者的圆形小阴影均在肺的后部分布较多.6例无尘肺(0期)和50例呈弥漫性圆形小阴影的尘肺患者的CT显示,结节呈小叶中心分布lO例(0期4例、Ⅰ期6例),呈淋巴管周围分布46例(0期2例、Ⅰ期1例、Ⅱ期13例、Ⅲ期30例).结论 圆形小阴影的分布特点有助于尘肺的诊断及鉴别诊断.     

尘肺胸部圆形小阴影的影像学分布特点

目的 探讨尘肺胸部圆形小阴影的影像学分布特点.方法 回顾性分析在2006年3月至2008年5月间确诊的尘肺56例(Ⅰ期7例、Ⅱ期13例、Ⅲ36例)和6例无尘肺者的影像学表现.结果 1例Ⅲ期尘肺患者在X线胸片和CT上未见明确的圆形小阴影,5例Ⅲ期尘肺患者仅在大阴影附近有少许稀疏分布的圆形小阴影和无尘肺(0期)的6例患者只在CT扫描上有弥漫性分布的p影,其余50例尘肺患者在X线胸片和CT上均有弥漫性分布的圆形小阴影.50例中,于上、中肺区分布较多23例及上肺区分布较多18例,占82%;X线胸片显示,圆形小阴影在中、下肺区分布较多7例.CT显示,圆形小阴影以上、中肺区较多3例,在上、中、下肺区呈均匀分布4例.X线胸片显示,2例Ⅲ期尘肺的圆形小阴影在上、中、下肺区均匀分布,而CT显示以中肺区较多.除1例Ⅰ期尘肺的圆形小阴影在肺的前、中后部均匀分布外,其余49例尘肺患者的圆形小阴影均在肺的后部分布较多.6例无尘肺(0期)和50例呈弥漫性圆形小阴影的尘肺患者的CT显示,结节呈小叶中心分布lO例(0期4例、Ⅰ期6例),呈淋巴管周围分布46例(0期2例、Ⅰ期1例、Ⅱ期13例、Ⅲ期30例).结论 圆形小阴影的分布特点有助于尘肺的诊断及鉴别诊断.     

尘肺胸部圆形小阴影的影像学分布特点

目的 探讨尘肺胸部圆形小阴影的影像学分布特点.方法 回顾性分析在2006年3月至2008年5月间确诊的尘肺56例(Ⅰ期7例、Ⅱ期13例、Ⅲ36例)和6例无尘肺者的影像学表现.结果 1例Ⅲ期尘肺患者在X线胸片和CT上未见明确的圆形小阴影,5例Ⅲ期尘肺患者仅在大阴影附近有少许稀疏分布的圆形小阴影和无尘肺(0期)的6例患者只在CT扫描上有弥漫性分布的p影,其余50例尘肺患者在X线胸片和CT上均有弥漫性分布的圆形小阴影.50例中,于上、中肺区分布较多23例及上肺区分布较多18例,占82%;X线胸片显示,圆形小阴影在中、下肺区分布较多7例.CT显示,圆形小阴影以上、中肺区较多3例,在上、中、下肺区呈均匀分布4例.X线胸片显示,2例Ⅲ期尘肺的圆形小阴影在上、中、下肺区均匀分布,而CT显示以中肺区较多.除1例Ⅰ期尘肺的圆形小阴影在肺的前、中后部均匀分布外,其余49例尘肺患者的圆形小阴影均在肺的后部分布较多.6例无尘肺(0期)和50例呈弥漫性圆形小阴影的尘肺患者的CT显示,结节呈小叶中心分布lO例(0期4例、Ⅰ期6例),呈淋巴管周围分布46例(0期2例、Ⅰ期1例、Ⅱ期13例、Ⅲ期30例).结论 圆形小阴影的分布特点有助于尘肺的诊断及鉴别诊断.     

尘肺胸部圆形小阴影的影像学分布特点

目的 探讨尘肺胸部圆形小阴影的影像学分布特点.方法 回顾性分析在2006年3月至2008年5月间确诊的尘肺56例(Ⅰ期7例、Ⅱ期13例、Ⅲ36例)和6例无尘肺者的影像学表现.结果 1例Ⅲ期尘肺患者在X线胸片和CT上未见明确的圆形小阴影,5例Ⅲ期尘肺患者仅在大阴影附近有少许稀疏分布的圆形小阴影和无尘肺(0期)的6例患者只在CT扫描上有弥漫性分布的p影,其余50例尘肺患者在X线胸片和CT上均有弥漫性分布的圆形小阴影.50例中,于上、中肺区分布较多23例及上肺区分布较多18例,占82%;X线胸片显示,圆形小阴影在中、下肺区分布较多7例.CT显示,圆形小阴影以上、中肺区较多3例,在上、中、下肺区呈均匀分布4例.X线胸片显示,2例Ⅲ期尘肺的圆形小阴影在上、中、下肺区均匀分布,而CT显示以中肺区较多.除1例Ⅰ期尘肺的圆形小阴影在肺的前、中后部均匀分布外,其余49例尘肺患者的圆形小阴影均在肺的后部分布较多.6例无尘肺(0期)和50例呈弥漫性圆形小阴影的尘肺患者的CT显示,结节呈小叶中心分布lO例(0期4例、Ⅰ期6例),呈淋巴管周围分布46例(0期2例、Ⅰ期1例、Ⅱ期13例、Ⅲ期30例).结论 圆形小阴影的分布特点有助于尘肺的诊断及鉴别诊断.     

尘肺胸部圆形小阴影的影像学分布特点

目的 探讨尘肺胸部圆形小阴影的影像学分布特点.方法 回顾性分析在2006年3月至2008年5月间确诊的尘肺56例(Ⅰ期7例、Ⅱ期13例、Ⅲ36例)和6例无尘肺者的影像学表现.结果 1例Ⅲ期尘肺患者在X线胸片和CT上未见明确的圆形小阴影,5例Ⅲ期尘肺患者仅在大阴影附近有少许稀疏分布的圆形小阴影和无尘肺(0期)的6例患者只在CT扫描上有弥漫性分布的p影,其余50例尘肺患者在X线胸片和CT上均有弥漫性分布的圆形小阴影.50例中,于上、中肺区分布较多23例及上肺区分布较多18例,占82%;X线胸片显示,圆形小阴影在中、下肺区分布较多7例.CT显示,圆形小阴影以上、中肺区较多3例,在上、中、下肺区呈均匀分布4例.X线胸片显示,2例Ⅲ期尘肺的圆形小阴影在上、中、下肺区均匀分布,而CT显示以中肺区较多.除1例Ⅰ期尘肺的圆形小阴影在肺的前、中后部均匀分布外,其余49例尘肺患者的圆形小阴影均在肺的后部分布较多.6例无尘肺(0期)和50例呈弥漫性圆形小阴影的尘肺患者的CT显示,结节呈小叶中心分布lO例(0期4例、Ⅰ期6例),呈淋巴管周围分布46例(0期2例、Ⅰ期1例、Ⅱ期13例、Ⅲ期30例).结论 圆形小阴影的分布特点有助于尘肺的诊断及鉴别诊断.     

误诊为肺部感染的抗中性粒细胞胞浆抗体相关性小血管炎的CT表现

目的探讨以肺部症状为首发的抗中性粒细胞胞浆抗体(ANCA)相关性小血管炎误诊为肺部感染的CT表现,旨在提高对该类疾病的肺部影像学认识,减少误诊率。方法回顾10例经穿刺活检及临床证实的以肺部症状为首发的ANCA相关性小血管炎误诊为肺部感染的CT表现,结合文献进行分析。结果在10例以肺部症状为首发的ANCA相关性小血管炎中,肺内弥漫性磨玻璃影两例,占20.0%,弥漫粟粒影1例,占10.0%;间质性改变3例,占30.0%,其中网格状2例,蜂窝状1例,小叶间隔增厚两例;多发斑片及片状影4例,占40.0%,边缘模糊,密度不均,其中充气支气管征3例、伴多发结节3例、形成空洞两例;伴有纵隔淋巴结肿大3例、胸腔积液3例、心包积液1例;误诊为普通间质性肺炎3例、细菌性肺炎3例、粟粒型肺结核、浸润型肺结核、卡氏肺孢子虫肺炎及真菌性肺炎各1例。结论以肺部症状为首发的ANCA相关性小血管炎肺部CT表现复杂多样,易误诊为感染性病变,应结合临床实验室及病理检查作出正确诊断。     

肺淋巴管肌瘤病的高分辨率CT表现

目的 探讨肺淋巴管肌瘤病的高分辨率CT（HRCT）特点,以提高对本病的诊断水平.方法 回顾性分析13例经病理证实的肺淋巴管肌瘤病患者胸部HRCT改变.结果 13例均为女性,年龄28 ～ 57岁,平均40岁.11例患者胸部HRCT表现为两肺均匀分布、多发的薄壁气囊影,直径数毫米至2 cm,囊壁厚1～2mm,气囊影无分布差异;囊腔周围为正常肺组织;2例患者弥漫分布大小不一囊腔、周围未见明显正常肺组织.1例患者左侧胸腔积液、腹膜后多发淋巴结肿大.结论 肺淋巴管肌瘤病的HRCT表现具有特征性,是诊断本病首选的影像学检查方法.     

胸部损伤的多层螺旋CT表现及重建技术的临床应用

目的探讨多层螺旋CT（MSCT）及重建技术对胸部外伤患者的临床应用。方法回顾性分析62例内蒙古医学院附属人民医院2006年3月—2008年12月收治62例胸部创伤患者,全部患者在伤后进行了MSCT检查,对骨性胸廓、肺组织进行容积再现（VR）重建、多平面重建（MPR）等图像后处理。结果62例患者多伴有复合伤,其中肺挫伤47例,肺撕裂伤3例,肺不张及肺萎缩9例,气胸35例,胸腔积液40例,肋骨骨折58例,肩胛骨骨折4例,锁骨骨折7例,胸椎骨折3例。MPR图像可清楚显示骨折线的走行及移位,VR重建图像从各个方位显示了骨折的空间改变。结论MSCT扫描结合重建图像能够清晰显示肺部损伤、显示骨折的立体空间改变,对于制定手术方案、判断预后具有重要的临床价值。     

Role of computed tomography in evaluating asbestos related lung disease

To find how computed tomography (CT) may be effectively used in individuals with suspected asbestos related lung disease 30 men with a history of exposure to asbestos were studied. All subjects underwent high kilovoltage posteroanterior and left lateral chest radiographs and chest CT. Eighteen were randomly selected asbestos workers referred for routine surveillance. The remaining 12 were patients who had been referred for investigation of respiratory symptoms or abnormal routine chest radiograph, or both, and found to have chest radiographic changes compatible with asbestos related lung disease. In the group referred for routine surveillance both pleural shadowing and pulmonary shadowing were shown on CT but not chest radiographs in only one case. Five were thought to have pleural shadowing on chest radiographs but this was confirmed on CT in only one case. All 12 patients referred for investigation showed pleural shadowing on chest radiographs; this was confirmed in all cases on CT which also showed unsuspected pulmonary shadowing in five cases. These findings suggest that it is not appropriate to use chest CT routinely in all asbestos workers referred for routine surveillance. When CT is used selectively in those with pleural shadowing on plain chest radiography, however, it is helpful in refuting or confirming the presence of pleural disease and may show unsuspected pulmonary shadowing.     

Role of computed tomography in evaluating asbestos related lung disease.

To find how computed tomography (CT) may be effectively used in individuals with suspected asbestos related lung disease 30 men with a history of exposure to asbestos were studied. All subjects underwent high kilovoltage posteroanterior and left lateral chest radiographs and chest CT. Eighteen were randomly selected asbestos workers referred for routine surveillance. The remaining 12 were patients who had been referred for investigation of respiratory symptoms or abnormal routine chest radiograph, or both, and found to have chest radiographic changes compatible with asbestos related lung disease. In the group referred for routine surveillance both pleural shadowing and pulmonary shadowing were shown on CT but not chest radiographs in only one case. Five were thought to have pleural shadowing on chest radiographs but this was confirmed on CT in only one case. All 12 patients referred for investigation showed pleural shadowing on chest radiographs; this was confirmed in all cases on CT which also showed unsuspected pulmonary shadowing in five cases. These findings suggest that it is not appropriate to use chest CT routinely in all asbestos workers referred for routine surveillance. When CT is used selectively in those with pleural shadowing on plain chest radiography, however, it is helpful in refuting or confirming the presence of pleural disease and may show unsuspected pulmonary shadowing.     

Bronchiectasis in rheumatoid arthritis. High resolution computed pulmonary tomography

To evaluate the prevalence of bronchiectasis in rhumatoid arthritis (RA) we have study thirty patients (24 women and 6 men), with a mean age of 45,2 years. All patients have a RA with a follow up of 5,84 years, positive rhumatoid factor were found in 22 cases. All patients have had high resolution computed pulmonary tomography, study of clinical, radiological and spirometry parameters. Bronchiectasis was found in 5 cases (16,6%) and is the most frequent abnormality found. These bronchiectasis are associated to an interstitial syndrome (2 cases) and pleural node (1 case). We don't find any significant difference in rhumatoid factor, extra-articular involvements, respiratory manifestations, smoke use or spirometry parameters between the sub group with or without bronchiectasis.     

Non-malignant chest x ray changes in patients with mesothelioma in a large cohort of asbestos insulation workers

To assess the prevalence of non-malignant chest x ray abnormalities in cases of mesothelioma 184 cases of mesothelioma (72 pleural and 112 peritoneal) which had occurred in a cohort of asbestos insulation workers followed up since 1967 were studied. Chest x ray films of satisfactory quality, on which the presence or absence of non-malignant radiological changes indicating interstitial pulmonary fibrosis or pleural fibrosis or both, could be assessed with a high degree of certainty were available. In some cases (20% for pleural mesothelioma, 11.6% for peritoneal mesothelioma) non-malignant radiological changes were not radiologically detectable. Parenchymal interstitial fibrosis (small irregular opacities) only was found in a proportion of cases (25.4% of pleural mesotheliomas, 12.5% of peritoneal mesotheliomas). Pleural fibrosis only was detected in 17% of cases of pleural mesothelioma and 27% of cases of peritoneal mesothelioma. Most patients had both parenchymal and pleural fibrosis. Although these results tend to indicate that in peritoneal mesothelioma the proportion of pleural fibrosis is significantly higher, these findings might have been due to the fact that in most cases of pleural mesothelioma non-malignant changes were interpreted in one hemithorax only. In 46 cases (21 pleural, 25 peritoneal) in which sufficient lung tissue was available histopathology of lung parenchyma indicated the presence of interstitial fibrosis; in 20 (43.5%) of these the chest x ray film had been read as negative. Thus the absence of radiologically detectable small opacities on the chest x ray film does not exclude the existence of interstitial pulmonary fibrosis in cases of mesothelioma among insulation workers. With lower levels of exposure (such as in family contacts of asbestos workers) it is conceivable that mesothelioma might occur in the absence of interstitial pulmonary fibrosis.     

Non-malignant chest x ray changes in patients with mesothelioma in a large cohort of asbestos insulation workers.

To assess the prevalence of non-malignant chest x ray abnormalities in cases of mesothelioma 184 cases of mesothelioma (72 pleural and 112 peritoneal) which had occurred in a cohort of asbestos insulation workers followed up since 1967 were studied. Chest x ray films of satisfactory quality, on which the presence or absence of non-malignant radiological changes indicating interstitial pulmonary fibrosis or pleural fibrosis or both, could be assessed with a high degree of certainty were available. In some cases (20% for pleural mesothelioma, 11.6% for peritoneal mesothelioma) non-malignant radiological changes were not radiologically detectable. Parenchymal interstitial fibrosis (small irregular opacities) only was found in a proportion of cases (25.4% of pleural mesotheliomas, 12.5% of peritoneal mesotheliomas). Pleural fibrosis only was detected in 17% of cases of pleural mesothelioma and 27% of cases of peritoneal mesothelioma. Most patients had both parenchymal and pleural fibrosis. Although these results tend to indicate that in peritoneal mesothelioma the proportion of pleural fibrosis is significantly higher, these findings might have been due to the fact that in most cases of pleural mesothelioma non-malignant changes were interpreted in one hemithorax only. In 46 cases (21 pleural, 25 peritoneal) in which sufficient lung tissue was available histopathology of lung parenchyma indicated the presence of interstitial fibrosis; in 20 (43.5%) of these the chest x ray film had been read as negative. Thus the absence of radiologically detectable small opacities on the chest x ray film does not exclude the existence of interstitial pulmonary fibrosis in cases of mesothelioma among insulation workers. With lower levels of exposure (such as in family contacts of asbestos workers) it is conceivable that mesothelioma might occur in the absence of interstitial pulmonary fibrosis.     

Pulmonary fibrosis in asbestos insulation workers with lung cancer: a radiological and histopathological evaluation.

This study was undertaken to determine the relation between radiographic and histological manifestations of pulmonary asbestosis (interstitial fibrosis) in insulation workers who had died of lung cancer. Of 450 confirmed deaths from lung cancer a chest radiograph suitable for determining evidence of pneumoconiosis was obtained in 219. Of these cases, 138 also had a tissue specimen submitted that was suitable for histological study to determine the extent of histological fibrosis. There was a significant albeit limited correlation between the radiographic and histological findings (r = 0.27, p less than 0.0013). All 138 cases had histological evidence of parenchymal fibrosis; in 25 (18%), however, there was no radiographic evidence of parenchymal fibrosis. In 10 cases (7%) both parenchymal and pleural disease were undetectable on the radiograph. Thus a negative chest radiograph does not exclude the presence of interstitial fibrosis (asbestosis) in a substantial proportion of insulation workers previously exposed to asbestos who develop lung cancer.     

Pulmonary fibrosis in asbestos insulation workers with lung cancer: a radiological and histopathological evaluation

This study was undertaken to determine the relation between radiographic and histological manifestations of pulmonary asbestosis (interstitial fibrosis) in insulation workers who had died of lung cancer. Of 450 confirmed deaths from lung cancer a chest radiograph suitable for determining evidence of pneumoconiosis was obtained in 219. Of these cases, 138 also had a tissue specimen submitted that was suitable for histological study to determine the extent of histological fibrosis. There was a significant albeit limited correlation between the radiographic and histological findings (r = 0.27, p less than 0.0013). All 138 cases had histological evidence of parenchymal fibrosis; in 25 (18%), however, there was no radiographic evidence of parenchymal fibrosis. In 10 cases (7%) both parenchymal and pleural disease were undetectable on the radiograph. Thus a negative chest radiograph does not exclude the presence of interstitial fibrosis (asbestosis) in a substantial proportion of insulation workers previously exposed to asbestos who develop lung cancer.