부산대학교 도서관

Chronic silicosis is a common form of silicosis, which is a fibrotic pulmonary disease induced by inhalation of respiratory crystalline silica. In addition to pulmonary nodular opacities, pleural involvement such as visceral pleural invagination and pleural thickening are well documented in chronic silicosis. Pleural effusion is a less common presentation of silicosis, but it has been reported as the primary presentation in a few cases. There is also increasing evidence that exposure to silica is associated with the formation of exudative pleural effusion. However, evidence for the use of medical thoracoscopy for the diagnosis of silicosis remains limited. Here, we reported the case of a 74-year-old male with decades of exposure to various kinds of dust. He was a former smoker with chronic obstructive pulmonary disease under medication control. He reported exertional dyspnea lasting for months, and chest X-ray showed blunting of the right costophrenic angle. His exudative pleural effusion was drained, but the cause was still unknown after laboratory studies. A thoracoscopy was performed, which revealed several whitish pleural nodules. A pathological examination showed silicotic nodules, and thus silicosis was diagnosed.