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Old 10-09-2011
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Lungs Afircan American Woman with 9 Months of Cough

A 31-year-old African American woman was seen in the office because of a cough for nine months’ duration. It had become more persistent and severe during the past three months as well as productive of a small amount of white, foamy, non-bloody sputum. There had been no fever, chills, chest pain or night sweats during this period. She had noticed increasing shortness of breath on effort but could still walk two flights of stairs. She had a long history of methylphenidate abuse. She was skin-tested and gave markedly positive intradermal reactions to ragweed pollen and house dust extracts with history of hay fever 10 years ago. She worked for the Revlon Company (Producer of cosmetic materials) for 11 years and had been a quality control inspector for the last nine years, inspecting cosmetic grade talcum in Revlon Powder Cans. The patient appeared to be healthy and in no acute distress but coughed frequently throughout the examination. Both sides of the chest showed some limitation of expansion, but there were no intercostal retractions and percussion was normal. The breath sounds were markedly increased in intensity throughout (bronchial or bronchovesicular breathing) - There were fine rates and “musical squeaks” scattered at the left base and over the right tipper posterior chest. There was some wheezing over the right anterior chest. The chest X-ray showed diffuse reticular densities and hazy nodules throughout the middle portion of both lung fields. Low-power photomicrograph (original magnification, 40; hematoxylin-eosin stain) of a histologic specimen obtained with polarized light is shown below:

Afircan American Woman with 9 Months of Cough-image3179.jpg
click image to enlarge

What is the most likely diagnosis?

A) Asbestosis
B) Tuberculosis
C) Interstitial pulmonary fibrosis
D) Talc Pneumoconiosis
E) Coal-induced progressive massive pneumoconiosis
F) Sarcoidosis
G) Hypersensitivity pneumonitis


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  #2  
Old 10-09-2011
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D) Talc Pneumoconiosis
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Talc
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the Question and the picture is giving of the answer talc pnemoconiosis
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sound like talc pneumoconiosis but not sure
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Old 10-11-2011
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can anyone explaine why talc please?
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