Fujimoto Kiminori, Müller Nestor L, Kato Seiya, Terasaki Hiroshi, Sadohara Junko, Rikimaru Toru, Hayabuchi Naofumi
Department of Radiology, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan.
Chest. 2004 Feb;125(2):737-43. doi: 10.1378/chest.125.2.737.
The purpose of this study was to describe the clinical, chest radiographic, high-resolution CT, and histopathologic features of clay dye "sendo" dust pneumoconiosis in seven rush mat ("tatami") workers.
Seven patients with a history of occupational exposure to sendo dust and radiographic changes suggestive of pneumoconiosis were retrospectively reviewed.
The duration of exposure ranged from 15 to 45 years (median, 30 years). Three patients had cough, and four patients had abnormal pulmonary function test results. Chest radiographs showed nodular opacities < 3 mm in diameter (types p and q) in all patients. The standard International Labor Office profusion score ranged from 0/1 to 1/1 (median, 1/0). High-resolution CT demonstrated small nodular opacities (types p and q) in all seven patients. In four patients, high-resolution CT demonstrated branching centrilobular structures, airway ectasia, airway wall thickening, and emphysematous changes. None of the patients had conglomerate nodules, large opacities, honeycombing, pleural effusion, or lymphadenopathy. Microscopic examination of the specimens obtained by open lung biopsy or transbronchial lung biopsy revealed nodular fibrosis with accumulation of dust-laden macrophages, but no silicotic nodules. Needle-like particles of 1 to 20 microm in length were evident among the dust deposits, and birefringent crystals were identified under polarizing microscopy. Four of seven patients showed intra-alveolar fibroblastic foci similar to Masson bodies, accompanied by dust deposition.
Rush mat workers' sendo dust pneumoconiosis is caused by dust containing free silica. The radiographic and high-resolution CT findings consist of small nodular opacities < 3 mm in diameter and bronchial and bronchiolar abnormalities.
本研究旨在描述7名蔺草席（“榻榻米”）工人的黏土染料“endo”粉尘肺尘埃沉着病的临床、胸部X线、高分辨率CT及组织病理学特征。
回顾性分析7例有职业性endo粉尘暴露史且胸部X线表现提示肺尘埃沉着病的患者。
暴露时间为15至45年（中位数为30年）。3例患者有咳嗽症状，4例患者肺功能测试结果异常。所有患者胸部X线均显示直径<3 mm的结节状阴影（p型和q型）。国际劳工组织标准密集度评分范围为0/1至1/1（中位数为1/0）。高分辨率CT显示所有7例患者均有小结节状阴影（p型和q型）。4例患者高分辨率CT显示有分支状小叶中心结构、气道扩张、气道壁增厚及肺气肿改变。所有患者均无融合结节、大阴影、蜂窝状改变、胸腔积液或淋巴结肿大。对开胸肺活检或经支气管肺活检获取的标本进行显微镜检查，发现有结节状纤维化，伴有含尘巨噬细胞积聚，但无矽结节。在粉尘沉积物中可见长度为1至20微米的针状颗粒，偏振显微镜下可识别出双折射晶体。7例患者中有4例显示肺泡内成纤维细胞灶，类似于马松小体，并伴有粉尘沉积。
蔺草席工人的endo粉尘肺尘埃沉着病由含游离二氧化硅的粉尘引起。胸部X线和高分辨率CT表现为直径<3 mm的小结节状阴影以及支气管和细支气管异常。
