PMC7569535_01
Scan of the chest. Initial presentation: axial (A), coronal (B) and sagittal (C) planes showing bilateral ground glass opacities surrounding cystic lesions or emphysematous destruction; (D) One year evolution with steroid treatment: regression of ground glass opacities
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F1
Histological analysis of the lung biopsy.. (A) Left lower lobe biopsy (HPS coloration, x4): Emphysema and desquamative interstitial pneumonia patterns, "plump" macrophages. Numerous giant-epithelioid granulomas without necrosis, granulomas with micro calcifications and Schaumann bodies.. (B) Left lower lobe biopsy (HPS coloration, x20): Pneumocytes hyperplasia, "plump" macrophages within alveolar spaces
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F2
We did not find foamy macrophage that could evoke an amiodarone impregnation (Fig. 2).
Mineralogical analysis of lung biopsies. Repartition diagram of mineralogical particles observed with microscope.. Comparison with a reference population (SEM-EDX in situ analysis of 53 blocks of pulmonary parenchyma from forensic institute of Lyon, 4050 particles analysed)
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F3
This analysis revealed abnormally high rates of zirconium compounds (5.2% versus 0.0%), aluminium compounds (4.4% versus 0.05%), aluminium oxide (2.0% versus 0.2%) and steel (14.0% versus 0.6%) in our patient compared to a reference population from the Forensic Institute of Lyon (Fig. 3) .