Gurney J W, Unger J M, Dorby C A, Mitby J K, Von Essen S G
Department of Radiology, University of Nebraska Medical Center, Omaha 68198.
Radiographics. 1991 Jul;11(4):625-34. doi: 10.1148/radiographics.11.4.1887117.
Agricultural workers are at risk for developing many respiratory tract disorders. Crop production disorders include chronic bronchitis, asthma, organic dust toxicity syndrome, chemical poisoning, farmer lung, and silo-filler disease. Livestock production disorders include toxic manure poisoning (dung lung) and several zoonoses. Radiographic manifestations can be classified into three patterns: (a) normal findings, characteristic of chronic bronchitis, asthma, or organic dust toxicity syndrome; (b) acute diffuse interstitial or alveolar pattern, characteristic of farmer lung, silo-filler disease, dung lung, and chemical poisoning; and (c) chronic interstitial pattern in the upper lobes (farmer lung) or lower lobes (silo-filler disease, paraquat poisoning). Differential diagnosis is aided by knowledge that most of these disorders have a seasonal presentation. Zoonoses generally exhibit focal areas of consolidation in the lung: The type of splenic calcification, presence of mediastinal or hilar adenopathy, and development of bronchiectasis are additional findings useful in differentiating these rare infections.
农业工人有患多种呼吸道疾病的风险。作物生产相关疾病包括慢性支气管炎、哮喘、有机粉尘中毒综合征、化学中毒、农民肺和谷仓装料工病。畜牧生产相关疾病包括有毒粪便中毒（粪肺）和几种人畜共患病。影像学表现可分为三种类型：（a）正常表现，见于慢性支气管炎、哮喘或有机粉尘中毒综合征；（b）急性弥漫性间质或肺泡型，见于农民肺、谷仓装料工病、粪肺和化学中毒；（c）上叶（农民肺）或下叶（谷仓装料工病、百草枯中毒）的慢性间质型。了解这些疾病大多有季节性表现有助于鉴别诊断。人畜共患病肺部通常表现为局灶性实变区域：脾脏钙化类型、纵隔或肺门淋巴结肿大情况以及支气管扩张的出现是有助于鉴别这些罕见感染的其他表现。
