PMC7227740_01
Chest X ray (PA view) showing bilateral nodular opacities in all zones
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F1
X ray of chest (postero-anterior view) showed bilateral nodular opacities in all zones [Figure 1].
2a) HRCT chest: Bilateral numerous reticular with fibrolinear densities in both upper lobes. 2b) Bilateral lung showing multiple reticular densities. 2c) Multiple nodular lesions in sub-pleural aspect of the right lower lobe with reticular densities in both lower lobes. 2d) Coronal section of lung showing multiple bilateral reticular densities all lobes
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F2
HRCT chest showed numerous reticulonodular densities in bilateral lung fields and multiple nodular lesions in the sub-pleural aspect of the right lower lobe with fibrolinear densities in both upper lobes [Figure 2a-d].
(a) Histopathology showed heavy deposition of coarse dark to brown pigment and mild chronic inflammation with focal interstitial fibrosis. (b) Iron stain with prussian blue shows fine and coarse granules in macrophages
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F3
Iron stain shows fine and coarse granules in macrophages on prussian blue. [Figure 3a and b] He was finally diagnosed as pulmonary siderosis, ATT was stop and advised to change occupation and use of protective gear while working.