Authors
Itsna Arifatuz Zulfiyah, Irmi Syafaah, Resti Yudhawati Meliana, Fierly Hayati, Priangga Adi Wiratama, Wiwin Is Effendi, Garinda Alma Duta, Faradila Nur Aini
Published in
Respiratory medicine case reports. Volume 63. Pages 102460. Epub Jul 07, 2026.
Abstract
Silicosis is typically associated with high-risk industries like mining, making its occurrence in the rubber manufacturing sector exceptionally rare. The advanced form, progressive massive fibrosis (PMF), presents a significant diagnostic challenge as it frequently mimics lung malignancy radiologically and tuberculosis histopathologically.
A 51-year-old female rubber factory worker with a 23-year history of exposure to talc-based anti-adherent powder presented with dyspnea and bilateral upper lobe masses, initially suspected to be lung cancer. Six years prior, she had been misdiagnosed and treated for tuberculosis based on the presence of giant cells in a lung biopsy. In the current admission, contrast-enhanced CT revealed large, non-enhancing masses accompanied by characteristic eggshell calcifications in the mediastinal lymph nodes, suggesting a non-malignant etiology. The definitive diagnosis was established through the integration of pathology and polarized light microscopy. A retrospective review of the previous biopsy reclassified the giant cells from the Langhans type to foreign body giant cells, while polarized light microscopy revealed birefringent polyhedral silica particles dispersed within the fibrous tissue.
This case highlights the diagnostic hazards of overlooking occupational history in low-risk sectors. Progressive massive fibrosis presents a dual diagnostic pitfall by radiologically mimicking malignancy and histopathologically mimicking tuberculosis.
PMID:
42471905
Bibliographic data and abstract were imported from PubMed on 19 Jul 2026.
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