A stone quarry worker with 20 years of dust exposure has progressive exertional dyspnea. Chest radiograph shows small rounded opacities in the upper zones and calcified hilar lymph nodes with a rim-like pattern. He also has a higher lifetime incidence of mycobacterial infection than the general population. Which diagnosis fits best?
- A Asbestosis
- B Silicosis ✓
- C Coal workers' pneumoconiosis
- D Berylliosis
Correct answer: B. Silicosis
Explanation
Free crystalline silica exposure produces upper-zone nodular fibrosis with pathognomonic eggshell calcification of hilar nodes, and silica impairs macrophage function, markedly increasing tuberculosis risk (silicotuberculosis). Asbestosis affects the lower zones with pleural plaques rather than eggshell nodes, coal workers' pneumoconiosis produces carbon-dusted macules without eggshell calcification or TB predisposition, and berylliosis is a granulomatous disease resembling sarcoidosis seen in aerospace and electronics workers.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.