Diffuse interlobular septal thickening in a coal miner

Abstract

Diffuse interlobular septal thickening (DIST) is an abnormality seen on high-resolution CT (HRCT) scanning of the thorax. While DIST may be present to variable extents in a number of lung conditions, it is uncommon as a predominant finding except in a few entities. This report features an ex-coal miner, thought to have coal workers' pneumoconiosis (CWP), in whom the HRCT scan showed no evidence of CWP and instead showed DIST. The patient's condition progressed incessantly towards death from severe secondary pulmonary hypertension. The case links fatal pulmonary hypertension to DIST, a pattern not previously described in coal workers.

Role of Chest Computed Tomography in Prevention of Occupational Respiratory Disease: Review of Recent Literature

“…There were 47 original investigations touching on use of chest CT for work-related conditions (►Table 1). In general, case reports were not selected, but 2 of the 47 were included because they demonstrated novel and potentially useful high-resolution CT (HRCT) patterns after exposure to coal mine dust 7 and tungsten/hard metal. 8 There were 17 reviews and 1 proceeding report (►Table 2).…”

“…53 Case reports of potentially novel findings in response to exposures documented diffuse ground glass opacities resembling hypersensitivity pneumonitis after exposure to hard metal 8 and diffuse interlobar septal thickening after exposure to coal mine dust. 7 Other articles described CT findings after exposure to World Trade Center dust, 54 in Turkish coppersmiths, 55 in dieselexposed toll collectors, 56 and in workers exposed to polyvinyl chloride dust. 57 One article notes the usefulness of 18-fluorine-labeled 2-deoxy-2-fluoro-D-glucose positron emission tomography/CT (FDG-PET/CT) in evaluating local extent, lymph node involvement, and metastasis of epithelial malignant mesothelioma.…”

Coal Mine Dust Desquamative Chronic Interstitial Pneumonia: A Precursor of Dust-Related Diffuse Fibrosis and of Emphysema

“…We have noted the coal mine dust desquamative chronic interstitial pneumonia in 100% of our autopsy cases with progressive massive pulmonary fibrosis. According to the literature, we could expect that on imaging studies, coal mine dust desquamative chronic interstitial pneumonia will present with irregular opacities 14 and a network of septal lines surrounding pulmonary lobules due to diffuse interlobular septal thickening 15 . We have also confirmed the finding that coal mine dust causes centriacinar emphysema.…”