Talc
pneumoconiosis: a pathologic and mineralogic study.Hum
Pathol. 1992 Dec;23(12):1344-54
Seventeen cases
of "talc pneumoconiosis" were examined pathologically and
mineralogically to ascertain whether a true talc pneumoconiosis
existed and also to compare these results in primary, secondary, and
tertiary exposures. Mineralogic analyses were performed on wet
tissue or tissue blocks by a variety of techniques, including
analytical transmission electron microscopy and x-ray diffraction.
Overall, the pathologic appearance of the tissues was similar in
primary, secondary, and tertiary exposures, although ferruginous
bodies and foreign body giant cells were not always present in cases
caused by secondary exposures. Mixed dust fibrotic lesions were
found in two cases in which there were substantial quantities of
quartz present. There was great variation in the minerals found
within the lung tissues. Several cases showed significant quantities
of mica and kaolin in addition to talc. One case consisted
predominantly of mica and in fact could be regarded as "mica
pneumoconiosis"; this diagnosis was correctly attributed because of
the mineralogic findings. Tremolite fibers were found in only two
cases. Substantial quantities of crocidolite and amosite fibers were
found in one case. This study shows that "talcosis" frequently
represents disease associated with a variety of minerals and that
talc is a common denominator. It shows also the usefulness of lung
dust mineral analysis, particularly in secondary industries, for
evaluating the cause of a pathologic reaction when exposures are
especially complex.
Inhalational
talc pneumoconiosis: radiographic and CT findings in 14 patients. AJR
Am J Roentgenol. 2007 Feb;188(2):326-33.
OBJECTIVE: The
purpose of this study was to evaluate the radiographic and CT
findings of inhalational talc pneumoconiosis. CONCLUSION: Large
opacities of talc pneumoconiosis progress more often than do small
opacities. The CT findings of talc pneumoconiosis overlap those of
silicosis and asbestosis.
Inhalational
pulmonary talcosis: high-resolution CT findings in 3 patients.J
Thorac Imaging. 2004 Jan;19(1):41-4
We describe the
high-resolution CT findings in 3 patients with pulmonary talcosis
acquired by the inhalation of talc. The predominant abnormalities
consisted of small centrilobular and subpleural nodules and
conglomerated masses containing focal areas of high attenuation
consistent with talc deposition. All patients also had focal ground
glass opacities. The abnormalities were diffuse but were most severe
in the upper and middle lung zones with relative sparing of the lung
bases.
Hypercalcemia due to talc granulomatosis.Chest.
2000 Apr;117(4):1195-6.
Pulmonary
disease due to talc, a group of hydrous magnesium silicates, is
almost exclusively encountered after occupational exposure. One form
of this rare disorder is talc granulomatosis. In varying degrees,
hypercalcemia is typical of granulomatous disease but has not yet
been reported in talcosis. We report the case of a former mold maker
who presented with hypercalcemia. Laboratory findings indicated
extra-renal 1-alpha-hydroxylation of 25-hydroxyvitamin D. Pulmonary
infiltrates prompted a lung biopsy that disclosed talc
granulomatosis. We suggest that talc granulomatosis should be added
to the list of granulomatous disorders capable of causing
hypercalcemia due to increased extra-renal 1-alpha-hydroxylation of
25-hydroxyvitamin D.
Munchausen
syndrome presenting as pulmonary talcosis.
Arch Pathol Lab Med.
1999 Aug;123(8):736-8
We describe
a patient with self-induced inhalational pulmonary talcosis
originally diagnosed as asthma. A 35-year-old female respiratory
technologist developed severe asthma that was refractory to steroids
and methotrexate. An open lung biopsy specimen showed scattered
aggregates of refractile golden crystals within membranous and
respiratory bronchioles. The particles ranged in size from 30 to 100
microm and were birefringent when viewed with polarized light.
Following review of the lung biopsy specimen, the patient admitted
to regularly inhaling large amounts of hospital baby powder.
Analysis of the lung biopsy specimen and a sample of the hospital
baby powder by x-ray energy dispersion showed identical
spectroscopic peaks, including elemental peaks for magnesium
silicate. Many patients with self-induced illness lack the
picturesque symptomatology classically attributed to Munchausen
syndrome. Awareness of these more subtle and varied patterns of
presentation may aid in earlier recognition.
Interstitial
lung disease more than 40 years after a 5 year occupational exposure
to talc.
Eur Respir J. 1998 Jun;11(6):1412-5.
A 62 yr old
woman was initially diagnosed with sarcoidosis until a thoracoscopic
biopsy revealed the presence of numerous birefringent particles in
fibrotic areas of the centrilobular lung zones. These particles were
examined by electron microscopy and X-ray spectrometry and
characterized as impure talc. Further inquiry into her occupational
history revealed that she had worked from the age of 14-18 yrs in a
factory making rubber hoses, where she had had an intense exposure
to talc. There was no evidence of silicosis or asbestosis, and other
significant causes of interstitial lung disease were excluded. This
case emphasizes the importance of a thorough occupational history,
which may reveal a remote and forgotten exposure to a significant
cause of interstitial lung disease. Although this presentation of
talcosis is unusual, this case suggests that even a relatively
short, but presumably intense exposure to talc more than 40 yrs
previously may be a cause of progressive lung fibrosis.
Atypical
mycobacteriosis as a complication of talc pneumoconiosis.Eur
Respir J. 1996 Aug;9(8):1757-9
A 57 year old
man, receiving compensation for talc pneumoconiosis since 1977, was
admitted to hospital for the first time in 1987, with symptoms of
weight loss, fever, dyspnoea and productive cough. A chest
roentgenogram showed bilateral cavitation. Two years later,
Mycobacterium xenopi was found in sputum cultures. Despite specific
oral antibiotherapy, the patient's health deteriorated and he died
in 1990. To the best of our knowledge, this is the first reported
case of an association of talcosis with a M. xenopi pneumonia. The
relative timing of the two diseases suggests that talc
pneumoconiosis predisposed to the infection by M. xenopi.
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