2024 Volume 46 Issue 6 Pages 431-434
Background. Pneumoconiosis is an occupational lung disease caused by the inhalation of dust. The diagnosis is made based on the patient's history of dust inhalation and chest CT images. Bronchoscopy can effectively detect specific findings; however, a pathological evaluation is not mandatory for the diagnosis. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a useful tool for patients with pneumoconiosis and mediastinal lymphadenopathy. Case. A 52-year-old man presented to another hospital with dyspnea on exertion. He was referred to the pulmonary department of our hospital because abnormal shadows were found on chest radiography. CT scans taken at our hospital revealed granular shadows not only in the bronchiole area but also in the pleura. The #4R lymph node was enlarged. In addition to pneumoconiosis, the differential diagnosis included metastatic lung tumors and milliary tuberculosis. The patient was admitted to our hospital and underwent bronchoscopy. We collected samples from the right lung using transbronchial lung biopsy (TBLB), and from the #4R lymph node using EBUS-TBNA. In both cases, we found histiocytes phagocytizing coal dust, while polarized light microscopy revealed silica particles. Therefore, the patient was diagnosed with pneumoconiosis. Conclusion. Pathological evaluation of patients with undiagnosed pneumoconiosis patient reveals specific findings, such as silica. EBUS-TBNA is an effective procedure for patients with mediastinal lymphadenopathy.
