Tuberc Respir Dis.
2000 Feb;48(2):260-267. 10.4046/trd.2000.48.2.260.
A Case of Giant Cell Interstitial Pneumonia
- Affiliations
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- 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea.
- 2Department of Diagnostic Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea.
- 3Preventive Medicine, Medical College, Korea University, Seoul, Korea.
- KMID: 1877194
- DOI: http://doi.org/10.4046/trd.2000.48.2.260
Abstract
- Giant cell interstitial pneumonia, a synonym of (for) hard metal pneumoconiosis, is a unique form of pulmonary fibrosis resulting from an exposure to hard metal dust. A case of biopsy-proved giant cell interstitial pneumonia in the absence of appropriate history of exposure to hard metal dust is reported. The patient presented with clinical features of chronic interstitial lung disease or idiopathic pulmonary fibrosis. He worked in a chemical laboratory at a fertilizer plant(,)where he had been exposed to various chemicals such as benzene and toluene. He denied having any other hobby in his house or job at work which may have exposed him hard metal dust(.) High-resolution CT scan revealed multi-lobar distribution of ground glass opacity with peripheral and basal lung predominance. The retrieved fluid of bronchoalveolar lavage contained asbestos fiber and showed neutrophil predominance. Surgical lung biopsy was performed for a definite diagnosis. Lung specimen showed alveolar infiltration of numerous multinucleated giant cells with mild interstitial fibrosis. Upon detailed examination of the lung tissue, one asbestos body was found. An analysis for mineral contents in lung tissue was performed. Compared to with the control specimen, the amount of cobalt and several hard metal components in the lung tissue of this patient was ten times higher. We speculated that the inconsistency between occupational history and the findings of pathologic and mineralogical analyses could be explained by the difference in individual immunologic reactivity to hard metal dust despite the relatively small amount of unrecognized environmental exposure (ED: It's hard to understand what this phrase is trying to say).
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