PMC3976776_01
Chest X-ray: bilateral diffuse nodular opacities with bilateral pneumothorax.
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fig1
Admission chest radiograph showed bilateral, diffuse, well-defined large rounded nodular opacities with right secondary spontaneous pneumothorax (Figure 1).
(a) Lung parenchyma showed collagenous nodules (arrow) (H&E x100), (b) silicotic nodule: central zone of whorls of hyalinised fibrous tissue, midzone of concentrically arranged collagen fibres, and outer zone of randomly orientated collagen fibres and inflammatory cells (H&E x200), (c) periphery of the nodules with dust laden macrophages and lymphoid cells (H&E x200), inset: dust laden macrophages (H&E x400), and (d) polarized light microscopy, white spots which represent silica crystals (white arrow).
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fig2
H and E sections of bilateral lungs revealed multiple collagenous nodules, some of which coalesced to form larger nodules (Figures 2(a) and 2(b)). The periphery of the nodules contained dust laden macrophages and inflammatory cells, predominantly lymphocytes (Figure 2(c)). Under polarized light microscopy, lung tissue showed white spots which represented silica crystals (Figure 2(d)).