[Hard metal pulmonary fibrosis].

A 20-year-old labourer, employed in the metal powder industry, developed increasing shortness of breath and serious urge to cough after 2 1/4 years of exposition to cobalt and tungsten carbide powder. On admission 9 months later pulmonary changes were demonstrated radiographically indicating hard-metal-dust lung. Detailed clinical assessment including transpleural biopsy and lingula resection as well as histochemical investigations and follow-up observations permitted access to the pathogenesis and morphology of the disease. By introduction of steroid treatment, before conclusion of diagnostic steps, limitation of the inflammatory primary reaction was possible inasmuch as loss of pulmonary function could be arrested despite massive, histologically verified, tendency for fibrosis.