A Case of Accelerated Silicosis Mimicking Miliary Pulmonary Tuberculosis

Silicosis is a chronic fibrosing lung disease that is initiated by prolonged and extensive exposure to respirable free crystalline silica. Accelerated silicosis is rare and is clinically identical to the classic form of silicosis with the exception that the time from initial exposure to the onset of the disease is shorter and the rate of disease progression is drama- tically faster. We describe a case of accelerated silicosis, which mimicked miliary pulmonary tuberculosis. The patient had worked in a mine coal for a period of 9 years. Subsequently, he worked in construction dealing with cement and sand for 14 years until he visited this clinic. The clinical course was notable for the rapid progression of the radiological features of silicosis over a period of 2 months. Polarizing light microscopic studies of the biopsied specimens by a transb- ronchial lung biopsy showed polarizing particles, which were typical of silica. To the best of our knowledge, this is the first case report of accelerated silicosis in Korea. (Tuberc Respir Dis 2005; 59: 684-689)