A 45-year-old sandblaster presents with progressive exertional dyspnea and a chest X-ray showing bilateral upper-zone nodular opacities with 'eggshell calcification' of hilar lymph nodes. He has worked in a foundry for 18 years. Which occupational lung disease does this MOST likely represent?

• A Asbestosis
• B Coal workers' pneumoconiosis
• C Byssinosis
• D Silicosis ✓

Explanation

Silicosis presents with progressive upper-lobe nodular fibrosis and characteristically, eggshell calcification of hilar lymph nodes — calcification of the peripheral shell of hilar nodes — which is virtually pathognomonic for silicosis (though also seen rarely in sarcoidosis). Sandblasting generates free crystalline silica (quartz), causing silicotic nodules. Asbestosis produces lower-lobe changes and pleural plaques. Coal workers' pneumoconiosis shows perihilar nodules without eggshell calcification. Byssinosis is a reversible airway disorder in cotton workers without nodular fibrosis.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.