Open AccessSecondary pleuroparenchymal fibro-elastosis with airway-centered fibro-elastosis and con-strictive bronchiolitis associated with agriculture dust exposure
Author(s) -
Bart Vrugt,
Thomas Frauenfelder,
Holger Dressel,
Fabio Barresi,
Christian F. Clarenbach,
Barbara Kuhn
Publication year - 2018
Publication title -
case reports in clinical pathology
Language(s) - English
Resource type - Journals
eISSN - 2331-2734
pISSN - 2331-2726
DOI - 10.5430/crcp.v5n1p4
Subject(s) - medicine , bronchiolitis , pathological , idiopathic interstitial pneumonia , lung , pathology , airway , interstitial pneumonia , respiratory system , surgery
Pleuroparenchymal fibro-elastosis (PPFE) is a rare idiopathic interstitial pneumonia. Secondary forms of PPFE may occur in patients following lung- or bone marrow transplantation. Here we report a middle-aged woman who presented with dyspnea and cough. She had been working as a cleaning woman in an agriculture company and logistic firm. Chest HRCT was highly suggestive for PPFE. Histopathological examination of a surgical biopsy showed a pattern of PPFE with airway-centered fibro-elastosis, constrictive bronchiolitis and birefringent particles in the pathological areas only. Using transmission electron microscopy with X-ray diffraction (TEM/EDX) these particles were identified as quartz and silicates, both components generally found in soil. The present case illustrates that secondary PPFE may result from agricultural dust exposure and stresses the need for a careful workup of the occupational history.