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Hard-Metal Pneumoconiosis
Kyung Soo Lee, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Giant cell interstitial pneumonia (GIP)
            • Definitions

              • Pneumoconiosis resulting from inhalation of hard metal
                • Hard metals: Cobalt and cobalt alloys (e.g., tungsten)
                • Hypersensitivity reaction with histologic features of GIP
                • History of exposure to metal dust
                • Characteristic clinical features of shortness of breath, cough, and dyspnea on exertion over long period
                • Radiologic features of interstitial lung disease
                • ↑ concentration of cobalt in lung tissue

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    Selected References

                                    1. Khoor A et al: Giant cell interstitial pneumonia in patients without hard metal exposure: analysis of 3 cases and review of the literature. Hum Pathol. 50:176-82, 2016
                                    2. Choi JW et al: Giant cell interstitial pneumonia: high-resolution CT and pathologic findings in four adult patients. AJR Am J Roentgenol. 184(1):268-72, 2005
                                    3. Dunlop P et al: Hard metal lung disease: high resolution CT and histologic correlation of the initial findings and demonstration of interval improvement. J Thorac Imaging. 20(4):301-4, 2005
                                    4. Gotway MB et al: Hard metal interstitial lung disease: high-resolution computed tomography appearance. J Thorac Imaging. 17(4):314-8, 2002
                                    5. Akira M. Uncommon pneumoconiosis: CT and pathologic findings. Radiology 1995;197(2):403–409.
                                    6. Posgay M et al: Radiological aspects of hard metal disease. Rofo. 159(5):439-43, 1993
                                    7. Sprince NL et al: Cobalt exposure and lung disease in tungsten carbide production. A cross-sectional study of current workers. Am Rev Respir Dis. 138(5):1220-6, 1988
                                    8. Coates EO Jr et al: Diffuse interstitial lung disease in tungsten carbide workers. Ann Intern Med. 75(5):709-16, 1971
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Pathology

                                            • Clinical Issues

                                              TERMINOLOGY

                                              • Synonyms

                                                • Giant cell interstitial pneumonia (GIP)
                                              • Definitions

                                                • Pneumoconiosis resulting from inhalation of hard metal
                                                  • Hard metals: Cobalt and cobalt alloys (e.g., tungsten)
                                                  • Hypersensitivity reaction with histologic features of GIP
                                                  • History of exposure to metal dust
                                                  • Characteristic clinical features of shortness of breath, cough, and dyspnea on exertion over long period
                                                  • Radiologic features of interstitial lung disease
                                                  • ↑ concentration of cobalt in lung tissue

                                              IMAGING

                                              • General Features

                                                • Radiographic Findings

                                                  • CT Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          • Staging, Grading, & Classification

                                                            • Microscopic Features

                                                              CLINICAL ISSUES

                                                              • Presentation

                                                                • Demographics

                                                                  • Natural History & Prognosis

                                                                    • Treatment

                                                                      Selected References

                                                                      1. Khoor A et al: Giant cell interstitial pneumonia in patients without hard metal exposure: analysis of 3 cases and review of the literature. Hum Pathol. 50:176-82, 2016
                                                                      2. Choi JW et al: Giant cell interstitial pneumonia: high-resolution CT and pathologic findings in four adult patients. AJR Am J Roentgenol. 184(1):268-72, 2005
                                                                      3. Dunlop P et al: Hard metal lung disease: high resolution CT and histologic correlation of the initial findings and demonstration of interval improvement. J Thorac Imaging. 20(4):301-4, 2005
                                                                      4. Gotway MB et al: Hard metal interstitial lung disease: high-resolution computed tomography appearance. J Thorac Imaging. 17(4):314-8, 2002
                                                                      5. Akira M. Uncommon pneumoconiosis: CT and pathologic findings. Radiology 1995;197(2):403–409.
                                                                      6. Posgay M et al: Radiological aspects of hard metal disease. Rofo. 159(5):439-43, 1993
                                                                      7. Sprince NL et al: Cobalt exposure and lung disease in tungsten carbide production. A cross-sectional study of current workers. Am Rev Respir Dis. 138(5):1220-6, 1988
                                                                      8. Coates EO Jr et al: Diffuse interstitial lung disease in tungsten carbide workers. Ann Intern Med. 75(5):709-16, 1971