Chest Imaging

Progressive massive fibrosis

(PMF), complication of coal worker's pneumoconiosis and usually occurs only after long-term exposure to coal dust. It is well known that coal dust alone can cause PMF, but the role of silica in the production of PMF remains uncertain. Typically PMF starts as bilateral masses near the periphery of the lung, but these masses can be completely or predominantly unilateral. These masses have a variable shape but are often oval or round with lobular or irregular edges, especially at the medial border (Fig.1). Small irregular calcification may be present. As the name implies PMF masses enlarge over time; this enlargement is, however, very slow and an observable increase in diameter takes years. In some cases there is progressive migration toward the hilus.

JV

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Fig.1

CT scan in a patient with silicosis demonstrates bilateral masses of fibrosis. Small nodules are present in the superior segment of the left lower lobe, and irregular emphysematous spaces lateral to the left fibrotic mass. Nodular calcification is seen in the right hilum (arrow).
Progressive massive fibrosis, Fig.1