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Study Syllabus for Classification of Radiographs of Pneumoconioses

Radiograph Classification

Subset 3

Radiograph #28

Answer Key #28 (Updated 9/28/2023)

With a background of small pneumoconiotic opacities, the large opacity in the right upper/middle zone is consistent with a size A large opacity of pneumoconiosis (PMF, conglomerate mass). In addition to recording the opacity as consistent with PMF, if one is concerned that this might possibly represent a carcinoma, the reader should also record ca in 4B and the “Other Comments” Section 4D, as shown on the reporting form. (Note: we must CLARIFY THAT when a lesion is consistent with PMF, ca alone is not correct).  In Section 4B, ax and di were selected. Hilar adenopathy is also likely and designated by hi.

Radiograph #29

Answer Key #29

This is an example of image quality 2 since the left arm is superimposed over the left lateral chest wall which could be mistaken for pleural thickening. Mottle was also noted. This radiograph illustrates a combination of small rounded opacities, primarily r and secondarily, irregular opacities t. The profusion 2/2 represents a subjective average since the profusion of small opacities in the lower zones is less than their profusion in the middle and upper zones. In averaging profusion, the lower zones are excluded because there are two subcategories of profusion between them and the other involved zones. Note the poorly defined densities at the right fifth and seventh posterior ribs and at the left eighth posterior rib, reflecting callus formation at healed fracture sites. They should not be mistaken for large opacities and should be recorded in Section 4B as fr.

Radiograph #30

Answer Key #30

Several large opacities are present. Their areas when summed exceed the area of the right upper lung zone; therefore, they are recorded as size C in Section 2C. There are no pleural abnormalities. In Section 4B, di, em, id, ih, and pb were selected.