A 42-year-old coal miner presents with progressive exertional dyspnoea and bilateral upper lobe nodular opacities on chest X-ray. Spirometry shows FEV1/FVC ratio of 0.72. The MOST probable diagnosis and its classical radiological eponym are:
- A Coal Worker's Pneumoconiosis (CWP) — simple CWP (p/q/r nodular shadows) without eggshell calcification ✓
- B Silicosis with eggshell calcification of hilar lymph nodes
- C Asbestosis with basal pleural plaques and bilateral interstitial fibrosis
- D Byssinosis with Monday morning dyspnoea and air flow limitation on Mondays
Correct answer: A. Coal Worker's Pneumoconiosis (CWP) — simple CWP (p/q/r nodular shadows) without eggshell calcification
Explanation
Coal Worker's Pneumoconiosis (CWP) results from inhalation of coal mine dust (coal + silica). Simple CWP shows bilateral small rounded opacities (p: < 1.5 mm, q: 1.5–3 mm, r: 3–10 mm on ILO classification) predominantly in upper and mid zones without eggshell calcification — the latter being pathognomonic of silicosis (not CWP) due to silicate-driven hilar lymph node calcification. The obstructive pattern (FEV1/FVC 0.72) reflects concomitant bronchitis. Asbestosis causes lower lobe fibrosis and pleural plaques in insulation/asbestos workers.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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