Study Syllabus for Classification of Radiographs of Pneumoconioses

Clinical Overview

Central Role of Diagnostic Imaging

Overview of Nonimaging Clinical Tools in Lung Disease Diagnosis

Bronchoscopy and Surgical Lung Biopsy

For most occupational lung diseases, a careful occupational and environmental exposure history in combination with non-invasive clinical testing is adequate for diagnosis. Occasionally, however, fiberoptic bronchoscopy with bronchoalveolar lavage (BAL) and transbronchial biopsies may be clinically indicated. This is particularly true for the granulomatous lung diseases, where the finding of a lymphocytic alveolitis can be helpful in confirming a diagnosis of HP or when a positive BAL BeLPT is essential for the diagnosis of CBD. For fibrotic interstitial lung diseases (ILDs) and in some cases of presumptive occupational bronchiolitis, surgical lung biopsy may be important in confirming a diagnosis and for deciding whether systemic therapy (i.e., with oral corticosteroids or immunosuppressive agents) is warranted. With the availability of newer treatment modalities for usual interstitial pneumonitis (UIP)/idiopathic pulmonary fibrosis (IPF), histologic confirmation and differentiation from similar occupational ILDs may be clinically important.