A 55-year-old coal miner with 25 years of underground mining presents with progressive dyspnoea and bilateral upper lobe nodular opacities with 'eggshell' calcification of hilar lymph nodes on CT chest. The most likely diagnosis is:
- A Silicosis ✓
- B Asbestosis
- C Progressive Massive Fibrosis (PMF) due to coal worker's pneumoconiosis
- D Berylliosis
Correct answer: A. Silicosis
Explanation
Eggshell calcification of hilar lymph nodes (thin rim of calcium around the node) is the PATHOGNOMONIC radiological feature of SILICOSIS — not coal worker's pneumoconiosis (CWP) or asbestosis. Silicosis results from inhalation of crystalline silica (quartz) and affects miners, sandblasters, and stone cutters. Upper lobe nodules that may coalesce into progressive massive fibrosis occur in both CWP and silicosis, but eggshell calcification is specific to silicosis. Asbestosis shows lower lobe fibrosis and pleural plaques.
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.