• Yasutaka Mochizuka, Masato Kono, Mineo Katsumata, Ryutaro Hirama, Masayuki Watanuki, Yuiko Oshima, Kenichiro Takeda, Akari Tsutsumi, Hideki Miwa, Yoshihiro Miki, Dai Hashimoto, Noriyuki Enomoto, Yutaro Nakamura, Takafumi Suda, and Hidenori Nakamura.
• Department of Pulmonary Medicine, Seirei Hamamatsu General Hospital, Japan.
• Intern. Med. 2022 Feb 1; 61 (3): 395-400.

AbstractA 67-year-old man was admitted to our hospital with cough and fatigue. He had had long-term exposure to silica due to cement processing. Chest computed tomography showed bilateral centrilobular nodules, and hilar and mediastinal lymphadenopathy with calcification, suggesting chronic silicosis. Within a few months, these nodules enlarged, and bilateral patchy consolidations appeared. A lung biopsy revealed sarcoid-like granulomas with birefringent particles under polarized light without malignancy or infection. He was diagnosed with silicosis-associated sarcoid-like granulomatous lung disease, rather than sarcoidosis, according to the clinicopathological findings. His pulmonary manifestations improved after the discontinuation of silica exposure and combination therapy of corticosteroid and azathioprine.

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