What radiographic feature of nodular pneumoconioses is most strongly associated with respiratory deficits?
Progressive massive fibrosis (PMF), also known as conglomerate masses , is the radiographic feature most strongly associated with respiratory deficits. In PMF, the small nodular areas of fibrosis associated with nodular pneumoconioses progressively coalesce into large (>3 cm) fibrotic masses. These masses are typically found in the upper lung zones and result in fibrotic distortion of the surrounding lung parenchyma. All of the nodular pneumoconioses can cause PMF, but it is most strongly associated with silicosis. Many patients with simple silicosis (nodular interstitial disease without PMF) are clinically asymptomatic. Nearly all patients with complicated silicosis (nodular interstitial disease with PMF) have dyspnea, however. The causes of the nodular interstitial pattern are reviewed in the below table
Causes of Nodular Interstitial Lung Disease Pattern
| CATEGORY | DISEASES |
|---|---|
| Granulomatous diseases | Sarcoidosis |
| Miliary infections | |
| Tuberculosis | |
| Histoplasmosis | |
| Coccidioidomycosis | |
| Cryptococcosis | |
| Blastomycosis | |
| Hypersensitivity pneumonitis | |
| Nodular pneumoconiosis | Silicosis |
| Coal workers’ pneumoconiosis | |
| Berylliosis | |
| Talcosis | |
| Metastasis | Thyroid carcinoma |
| Other malignancies | |
| Smoking-related diseases | Langerhans cell histiocytosis |
| Respiratory bronchiolitis interstitial lung disease |
