Radiological findings on zirconium exposure; a case report


Demirci Atik M., Taylan A., Uçan E. S.

Türk Toraks Derneği 25. Yıllık Kongresi, 2022, Antalya, Türkiye, 24 - 28 Mayıs 2022, ss.670

  • Yayın Türü: Bildiri / Özet Bildiri
  • Basıldığı Şehir: Antalya
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayıları: ss.670
  • Dokuz Eylül Üniversitesi Adresli: Evet

Özet

INTRODUCTION: Pneumoconiosis is a lung disease that develops as a result of a tissue reaction that occurs with the accumulation of inorganic particles. Pathoclinical features may vary depending on the type of inhaled particle. Today, fibrotic and nonfibrotic tissue reactions are well defined in some substances. For example, it is known that exposures such as silica, asbestos, beryllium and talc are associated with fibrosis in the lung, while exposures such as iron, tin and barium sulfate cause nonfibrogenic changes. However, the pathoclinic and radiological findings of some rare exposures such as zirconium are not widely known yet.

CASE PRESENTATION: A 52-year-old male patient was admitted to occupational medicine clinic with complaints of dyspnea for the past month. He did not complain of cough and sputum. He had no previous history of tuberculosis. He had 30 pack-years of smoking history. He had not smoked for a month. In his family history, his father had a diagnosis of COPD. On physical examination, breath sounds were decreased. He stated that he had been a dental technician for 28 years. Especially for the last 26 years, he had been working only in the design and production of zirconium infrastructure. He was leveling zirconium products with a micromotor for an average of 3 hours a day. In his thorax HRCT (high resolution computed tomography ) findings, calcific ovoid shaped mediastinal lymph nodes and prominent parenchymal emphysematism and fibrotic densities in the upper zones were observed. He did not accept invasive intervention due to the risk of morbidity (pneumothorax, hemorrhage etc.). After excluding differential diagnoses, pneumoconiosis was considered in the case with exposure history, clinical and radiological findings.

CONCLUSION: When the toxic effects of zirconium were examined in the literature, lung fibrosis findings were shown in rat and hamster studies, and fibrosis and emphysematous changes were described radiologically in individual case reports. Although smoking was an important confounder in our case, it was thought that the radiological findings would contribute to the current literature in this case whose zirconium exposure was clearly defined.

Keywords: dental technician, pneumoconiosis, radiological findings, zirconium