case_images: PMC4922280_01
case_images: CT axial lung window showing scattered parenchymal opacities (black arrow a), wider parenchymal consolidations in the CT axial lung window (b, black arrow) and mediastinal window (c, black arrow), and CT-guided lung biopsy (needle pointed by black arrow d)
case_images: IJOEM-20-60-g001.jpg
case_images: PMC4922280_01_IJOEM-20-60-g001.jpg
case_images: F1
case_images: The computerized tomogram (CT) done 3 months prior to presentation showed nonspecific patchy parenchymal opacities [Figure 1a]. CT (HRCT) of the chest showed bilateral middle and lower lobe ground-glass opacities with left lower lobe consolidation [Figure 1b and c]. CT-guided biopsy of the left lower lobe lesion was performed [Figure 1d] to rule out the possibility of malignancy and histopathological examination showed features of interstitial pneumonia with fibrosis.
case_images: (a) Benign squamous cells, pigment laden macrophages and inflammatory cells (Pap, X100) (b) Extensive neutrophilic inflammation (Pap, X100) (c and d) Silica particles appearing as granular birefringent crystals (X200)
case_images: IJOEM-20-60-g002.jpg
case_images: PMC4922280_01_IJOEM-20-60-g002.jpg
case_images: F2
case_images: The papanicolaou (PAP) stain on bronchial lavage revealed benign squamous cells, pigment-laden macrophages, and extensive acute inflammatory cell infiltrate [Figure 2a and b]. Detection of numerous birefringent silica particles under polarizing microscope in the bronchial lavage [Figure 2c and d], otherwise not appreciable on PAP stain, clinched the primary diagnosis of silicosis with associated tuberculosis.