Case Report

Pulmonary Silicosis Presents with Pleural Effusion

Table 1

Summary of the reported cases of silicosis presenting with pleural effusion.

CaseAl-Kassimi’s case [7]Zeren et al.’s case [2]Our case

Age/sex70-year-old male57-year-old male77-year-old male

OccupationWell digging, no more exposurePlumbing fixture factory where he sprayed glazing compound, still exposedCarving and grinding stones, no more exposure

Occurrence of pleural effusion in relation to time of silica exposureMore than 40 years32 years More than 50 years

Onset of symptomsInsidious Subacute Acute on chronic

Presenting symptoms Shortness of breathShortness of breath, pleuritic chest pain, and feverShortness of breath

Radiographic changes of patient regarding silicosisChest X-ray showed bilateral interstitial shadowing more pronounced in the upper zones with massive pulmonary fibrosis as well as right pleural effusion (simple silicosis)The chest X-ray and CT scans showed thickening of the left pleura consistent with a chronic process and a small right pleural effusion (simple silicosis)The chest X-ray and CT scans showed bilateral pleural effusion and thickening with bilateral small irregular opacities (simple silicosis)

Transbronchial biopsyBirefringent particles compatible with silicosis; hyperplasia of mesothelial cellsMacrophage containing birefringent particles; hyperplasia of mesothelial cellsHistiocytes containing refractile foreign material, consistent with silicosis; hyperplasia of mesothelial cells

Pleural fluid analysis Exudative pleural effusion with high LDHNot reported Exudative pleural effusion with high LDH

Treatment & outcomesChemical pleurodesis; no recurrence in 3.5 yearsPatient changes his job and his symptoms spontaneously resolved, resolved in 1 month, no recurrence in 3 yearsMechanical pleurodesis; no recurrence in 12 months