Diagnostic challenges of radiological opacities in silicosis - case reports

Occupational exposure to crystalline silica dust in the workplace can cause lung damage (silicosis, chronic airflow limitation and lung cancer). Silicosis results from the fibrotic reaction to the deposition of inhaled crystalline silica dust in the lung tissue. Even though many coalmines and foundries have closed, crystalline silica is still widely used, making silicosis a significant public health issue. Occupational exposure to crystalline silica must be considered when diagnosing respiratory symptoms to avoid under- or misdiagnosis. The diagnosis of silicosis relies on acknowledging the causal relationship linked to exposure, the pulmonary radiological changes and the exclusion of other diseases with imaging or clinical characteristics similar to silicosis. The diagnosis is often not straightforward and, in many cases, histopathological examination is necessary for confirmation. In this case report, we present two cases in which an initial misdiagnosis led to inadequate treatment.