A miner working in silica-rich underground mines for 15 years presents with progressive dyspnoea, upper lobe fibrosis on HRCT, and 'eggshell' calcification of hilar lymph nodes. He develops Mycobacterium tuberculosis co-infection. This combination is called:

• A Caplan's syndrome
• B Progressive massive fibrosis (PMF)
• C Complicated silicosis with ABPA
• D Silicotuberculosis ✓

Explanation

Silicotuberculosis is the well-established co-occurrence of silicosis and tuberculosis. Silica dust impairs macrophage function and reduces alveolar macrophage killing of mycobacteria, dramatically increasing TB susceptibility (risk 2–4 fold higher). The classic radiological finding of eggshell calcification of hilar nodes is pathognomonic of silicosis. Caplan's syndrome is the combination of pneumoconiosis (coal worker's or silicosis) with rheumatoid arthritis, presenting as peripheral lung nodules. Progressive massive fibrosis (PMF) describes end-stage conglomerate fibrosis in coal workers' pneumoconiosis or silicosis without necessarily implying TB.

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.