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Published on: June 16, 2020
Diffuse interlobular septal thickening in a coal miner
S G Thrumurthy1, S Kearney, M Sissons
1Department of Respiratory Medicine, Chorley and South Ribble Hospital, Lancashire Teaching Hospitals NHS Foundation Trust, Preston Road, Chorley PR7 1PP, UK.
Thorax
|December 24, 2009
Summary
Diffuse interlobular septal thickening (DIST), an uncommon CT finding, was linked to fatal pulmonary hypertension in an ex-coal miner. This case highlights a novel association not previously seen in coal workers
Area of Science:
- Pulmonary Medicine
- Radiology
- Occupational Health
Background:
- Diffuse interlobular septal thickening (DIST) is a radiological finding on thoracic high-resolution CT (HRCT).
- DIST is typically a minor feature in many lung diseases, but can dominate in specific conditions.
- Coal workers' pneumoconiosis (CWP) is an occupational lung disease common in coal miners.
Observation:
- A case report of an ex-coal miner initially suspected of having CWP.
- HRCT scans revealed DIST as the predominant abnormality, with no signs of CWP.
- The patient experienced progressive disease leading to death.
Findings:
- The patient developed severe secondary pulmonary hypertension.
- A direct link between DIST and fatal pulmonary hypertension was observed.
- This specific pattern of DIST associated with pulmonary hypertension was not previously documented in coal workers.
Implications:
- This case expands the understanding of DIST manifestations in occupational lung disease.
- It suggests a potential link between DIST and the development of severe pulmonary hypertension in susceptible individuals.
- Highlights the importance of considering alternative diagnoses when HRCT findings are atypical for suspected conditions like CWP.
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