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Study Syllabus for Classification of Radiographs of Pneumoconioses

Pathology Overview

Pathology Basis of Occupational Lung Disease


Tissue pathology is the standard upon which the radiographic recognition of pneumoconiotic lesions has historically been derived. It follows, therefore, that a knowledge of morphology helps to place radiologic findings into pathologic and clinical perspective, may improve diagnostic acumen, and lends credibility to the interpretation of radiologic images. The spectrum of pneumoconioses encompasses myriad injurious minerals inhaled in various occupational settings, and the patterns of lung remodeling differ with the inhaled agent (or agents), the intensity and duration of exposure, and mitigating intrinsic or extrinsic factors that affect tissue reaction and/or dust removal from the lung. Regardless of the inciting mineral, however, there are certain basic lesions that characterize diverse disease entities and impart similar appearances in the chest radiograph. The majority of cases of pneumoconiosis encountered radiologically are encompassed by the 3 classic disorders: silicosis,  asbestos-related pleuropulmonary disease, and CWP. An understanding of the pathology of these 3 entities thus serves as a foundation for radiologic interpretation of the pneumoconioses and, owing to the stereotyped responses of the lung to injury, is relevant for assessment of radiologic changes in less-frequent types of mineral dust exposures.