Journal List > Tuberc Respir Dis > v.72(2) > 1001724

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Kim, Park, Park, Kwon, and Kim: A Case of Welder's Lung Disease and Concurred Non-Tuberculotic Mycobacterial Infection Confirmed with Thoracoscopic Lung Biopsy
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2012; 72(2): 223-227.

Published online: 29 February 2012

DOI: https://doi.org/10.4046/trd.2012.72.2.223

A Case of Welder's Lung Disease and Concurred Non-Tuberculotic Mycobacterial Infection Confirmed with Thoracoscopic Lung Biopsy

Jung Ho Kim, M.D., Yun Jung Park, M.D., Ki Hoon Park, M.D., Soon Seog Kwon, M.D., Yong Hyun Kim, M.D.

Department of Internal Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Bucheon, Korea.

Address for correspondence: Yong Hyun Kim, M.D. Department of Internal Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, 2, Sosa-dong, Wonmi-gu, Bucheon 420-717, Korea. Phone: 82-70-4307-7656, Fax: 82-32-340-2039, kyh30med@catholic.ac.kr

Received 27 September 2011       Revised 10 October 2011       Accepted 17 December 2011

Copyright © 2012. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Pulmonary siderosis, or Welder's lung disease is an occupational lung disease caused by iron-inhalation. Diagnosis of pulmonary siderosis is based on occupational history of the patient, radiologic findings, and pathologic findings of iron-laden macrophages within lung tissue or broncho-alveolar lavage fluid. We observed a case of a 43 years-old welder diagnosed with pulmonary siderosis via thoracoscopic lung biopsy. Sputum culture along with pathology also identified a non-tuberculotic mycobacterial infection with a sputum culture and the pathologic findings. The patient was treated with anti-tubercular medication and cessation of iron-exposure. And his condition improved within a few months.

Keywords: Hemosiderosis, Pneumoconiosis, Mycobacterium Infections, Nontuberculous, Thoracic Surgery, Video-Assisted

Figures and Tables

Figure 1
Chest PA shows diffuse reticulo-nodular opacities on bilateral lung field. PA: posterior anterior.
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Figure 2
Chest CT shows 2.2×1.9 cm sized cavitary lesion in left upper lobe and fibrous scar in right upper lobe. It also shows widespread centri-lobular nodules with ground glass opacities. CT: computed tomography.
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Figure 3
Broncho-alveolar lavage fluid showed macrophages containing iron pigment. Iron pigments represented brown color in Periodic acid-Schiff stain, and deep blue color in Prussian blue stain (A, Periodic acid-Schiff stain, ×800; B, Prussian blue stain, ×800).
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Figure 4
(A) Brown pigmentation, iron compound deposited in the alveolar space and interstitial tissue (HE stain, ×400). (B) Many macrophages in the alveolar space shows blue cytoplasmic pigmentations (iron-particles; Prussian blue stain, ×400). (C) and (D), chronic granulomatous inflammation with multi-nucleated giant cells suggested mycobacterial infection (C, HE stain, ×40; D, HE stain, ×200).
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