Upper Lobe-Dominant Pulmonary Fibrosis Showing Deposits of Hard Metal Component in the Fibrotic Lesions

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Author(s)

    • Ishii Yukio
    • Department of Respiratory Medicine, University of Tsukuba
    • Moriyama Hiroshi
    • Division of Respiratory Medicine, Niigata University Graduate School of Medical and Dental Sciences
    • Terada Masaki
    • Division of Respiratory Medicine, Niigata University Graduate School of Medical and Dental Sciences
    • Suzuki Eiichi
    • Department of General Medicine, Niigata University Medical and Dental Hospital

Abstract

We present a 54-year-old man employed in the field of hard metal manufacturing who complained of progressive dyspnea and weight loss. His chest radiograph showed bilateral fibrosis predominantly distributed in the upper lobes with bilateral pleural effusions, and a strong reduction in lung volume. Lung histopathology showed apical cap-like fibrosis but no giant cell interstitial pneumonia. Electron probe microanalysis detected tungsten deposits in the fibrotic region: we therefore considered this to be a case of hard metal disease. Hard metal disease should be considered as one possibility in the differential diagnosis of upper lobe-dominant pulmonary fibrosis.<br>

Journal

  • Internal Medicine

    Internal Medicine 49(19), 2143-2145, 2010

    The Japanese Society of Internal Medicine

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