DOI QR코드

DOI QR Code

Occupational Lung Diseases: Spectrum of Common Imaging Manifestations

  • Alexander W. Matyga (Department of Radiology, Behavioral Sciences Department, University of Chicago) ;
  • Lydia Chelala (Department of Radiology, Cardiopulmonary Imaging, University of Chicago) ;
  • Jonathan H. Chung (Department of Radiology, Cardiopulmonary Imaging, University of Chicago)
  • Received : 2023.03.24
  • Accepted : 2023.06.15
  • Published : 2023.08.01

Abstract

Occupational lung diseases (OLD) are a group of preventable conditions caused by noxious inhalation exposure in the workplace. Workers in various industries are at a higher risk of developing OLD. Despite regulations contributing to a decreased incidence, OLD remain among the most frequently diagnosed work-related conditions, contributing to significant morbidity and mortality. A multidisciplinary discussion (MDD) is necessary for a timely diagnosis. Imaging, particularly computed tomography, plays a central role in diagnosing OLD and excluding other inhalational lung diseases. OLD can be broadly classified into fibrotic and non-fibrotic forms. Imaging reflects variable degrees of inflammation and fibrosis involving the airways, parenchyma, and pleura. Common manifestations include classical pneumoconioses, chronic granulomatous diseases (CGD), and small and large airway diseases. Imaging is influenced by the type of inciting exposure. The findings of airway disease may be subtle or solely uncovered upon expiration. High-resolution chest CT, including expiratory-phase imaging, should be performed in all patients with suspected OLD. Radiologists should familiarize themselves with these imaging features to improve diagnostic accuracy.

Keywords

References

  1. Cox CW, Rose CS, Lynch DA. State of the art: imaging of occupational lung disease. Radiology 2014;270:681-696  https://doi.org/10.1148/radiol.13121415
  2. Driscoll T, Nelson DI, Steenland K, Leigh J, Concha-Barrientos M, Fingerhut M, et al. The global burden of non-malignant respiratory disease due to occupational airborne exposures. Am J Ind Med 2005;48:432-445  https://doi.org/10.1002/ajim.20210
  3. Almberg KS, Halldin CN, Blackley DJ, Laney AS, Storey E, Rose CS, et al. Progressive massive fibrosis resurgence identified in U.S. coal miners filing for black lung benefits, 1970-2016. Ann Am Thorac Soc 2018;15:1420-1426  https://doi.org/10.1513/AnnalsATS.201804-261OC
  4. Onodera S. [Left ventricular function in pulmonary embolism]. Kokyu To Junkan 1975;23:315-323. Japanese 
  5. De Matteis S, Heederik D, Burdorf A, Colosio C, Cullinan P, Henneberger PK, et al. Current and new challenges in occupational lung diseases. Eur Respir Rev 2017;26:170080 
  6. Mazzei MA, Sartorelli P, Bagnacci G, Gentili F, Sisinni AG, Fausto A, et al. Occupational lung diseases: underreported diagnosis in radiological practice. Semin Ultrasound CT MR 2019;40:36-50  https://doi.org/10.1053/j.sult.2018.10.019
  7. Dodia N, Amariei D, Kenaa B, Corwin D, Chelala L, Britt EJ, et al. A comprehensive assessment of environmental exposures and the medical history guides multidisciplinary discussion in interstitial lung disease. Respir Med 2021;179:106333 
  8. Flors L, Domingo ML, Leiva-Salinas C, Mazon M, Rosello-Sastre E, Vilar J. Uncommon occupational lung diseases: high-resolution CT findings. AJR Am J Roentgenol 2010;194:W20-W26  https://doi.org/10.2214/AJR.09.2593
  9. Chong S, Lee KS, Chung MJ, Han J, Kwon OJ, Kim TS. Pneumoconiosis: comparison of imaging and pathologic findings. Radiographics 2006;26:59-77  https://doi.org/10.1148/rg.261055070
  10. Champlin J, Edwards R, Pipavath S. Imaging of occupational lung disease. Radiol Clin North Am 2016;54:1077-1096  https://doi.org/10.1016/j.rcl.2016.05.015
  11. Sirajuddin A, Kanne JP. Occupational lung disease. J Thorac Imaging 2009;24:310-320  https://doi.org/10.1097/RTI.0b013e3181c1a9b3
  12. Cha YK, Kim JS, Kim Y, Kim YK. Radiologic diagnosis of asbestosis in Korea. Korean J Radiol 2016;17:674-683  https://doi.org/10.3348/kjr.2016.17.5.674
  13. Akira M, Yamamoto S, Inoue Y, Sakatani M. High-resolution CT of asbestosis and idiopathic pulmonary fibrosis. AJR Am J Roentgenol 2003;181:163-169  https://doi.org/10.2214/ajr.181.1.1810163
  14. Akira M, Yokoyama K, Yamamoto S, Higashihara T, Morinaga K, Kita N, et al. Early asbestosis: evaluation with high-resolution CT. Radiology 1991;178:409-416  https://doi.org/10.1148/radiology.178.2.1987601
  15. Gamsu G, Salmon CJ, Warnock ML, Blanc PD. CT quantification of interstitial fibrosis in patients with asbestosis: a comparison of two methods. AJR Am J Roentgenol 1995;164:63-68  https://doi.org/10.2214/ajr.164.1.7998570
  16. Ogihara Y, Ashizawa K, Hayashi H, Nagayasu T, Hayashi T, Honda S, et al. Progressive massive fibrosis in patients with pneumoconiosis: utility of MRI in differentiating from lung cancer. Acta Radiol 2018;59:72-80  https://doi.org/10.1177/0284185117700929
  17. Marchiori E, Souza CA, Barbassa TG, Escuissato DL, Gasparetto EL, Souza AS Jr. Silicoproteinosis: high-resolution CT findings in 13 patients. AJR Am J Roentgenol 2007;189:1402-1406  https://doi.org/10.2214/AJR.07.2402
  18. Newman LS, Buschman DL, Newell JD Jr, Lynch DA. Beryllium disease: assessment with CT. Radiology 1994;190:835-840  https://doi.org/10.1148/radiology.190.3.8115636
  19. Chelala L, Adegunsoye A, Cody BA, Husain AN, Chung JH. Updated imaging classification of hypersensitivity pneumonitis. Radiol Clin North Am 2022;60:901-913  https://doi.org/10.1016/j.rcl.2022.06.013
  20. Raghu G, Remy-Jardin M, Ryerson CJ, Myers JL, Kreuter M, Vasakova M, et al. Diagnosis of hypersensitivity pneumonitis in adults. An official ATS/JRS/ALAT clinical practice cuideline. Am J Respir Crit Care Med 2020;202:e36-e69  https://doi.org/10.1164/rccm.202005-2032ST
  21. Fernandez Perez ER, Travis WD, Lynch DA, Brown KK, Johannson KA, Selman M, et al. Diagnosis and evaluation of hypersensitivity pneumonitis: CHEST guideline and expert panel report. Chest 2021;160:e97-e156  https://doi.org/10.1016/j.chest.2021.03.066
  22. Banks DE, Morris MJ. Inhalational constrictive bronchiolitis: the evolution of our understanding of this disease. Lung 2021;199:327-334  https://doi.org/10.1007/s00408-021-00466-2
  23. King MS, Eisenberg R, Newman JH, Tolle JJ, Harrell FE Jr, Nian H, et al. Constrictive bronchiolitis in soldiers returning from Iraq and Afghanistan. N Engl J Med 2011;365:222-230  https://doi.org/10.1056/NEJMoa1101388
  24. Jensen SP, Lynch DA, Brown KK, Wenzel SE, Newell JD. High-resolution CT features of severe asthma and bronchiolitis obliterans. Clin Radiol 2002;57:1078-1085 https://doi.org/10.1053/crad.2002.1104