Silicosis-related pleural effusion diagnosed using elemental analysis of the pleural fluid cell block: A case report

Shouichi Okamoto; Isao Kobayashi; Hiroshi Moriyama; Mayuka Tanimura; Kotaro Kadoya; Hiroki Ienaga; Toshiaki Kikuchi; Kazuhisa Takahashi

doi:10.1016/j.rmcr.2022.101665

Silicosis-related pleural effusion diagnosed using elemental analysis of the pleural fluid cell block: A case report

Respir Med Case Rep. 2022 May 11:37:101665. doi: 10.1016/j.rmcr.2022.101665. eCollection 2022.

Authors

Shouichi Okamoto^{1

2

3}, Isao Kobayashi¹, Hiroshi Moriyama⁴, Mayuka Tanimura², Kotaro Kadoya^{1

2}, Hiroki Ienaga², Toshiaki Kikuchi⁵, Kazuhisa Takahashi¹

Affiliations

¹ Division of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
² Department of Respiratory Medicine, Koshigaya Municipal Hospital, 10-32, Higashikoshigaya, Koshigaya, Saitama, 343-8577, Japan.
³ Department of Respiratory Medicine, Saiseikai Ibaraki Hospital, 2-1-45, Mitsukeyama, Ibaraki, Osaka, 567-0035, Japan.
⁴ Department of Respiratory Medicine, NishiNiigata Chuo Hospital, 1-14-1, Masago, Nishi-ku, Niigata, Niigata, 950-2085, Japan.
⁵ Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, 757-1 Asahimachi-dori, Chuo-ku, Niigata, 951-8520, Japan.

Abstract

Pleural disease in silicosis remains an underrecognized entity. Herein, we describe the case of an 85-year-old man with a 20-year history of silica exposure between the ages of 9-28 years. He presented with bilateral exudative pleural effusions, and chest computed tomography revealed typical silicosis findings. Thoracentesis was performed thrice, but did not reveal the cause of effusion. However, pleural fluid cell-block elemental analysis revealed a silicon compound, suggesting that silicosis-related pleural effusion had developed after a long latency period. Therefore, elemental analysis of the pleural fluid cell block may help diagnose occupational lung diseases with pleural effusion.

Keywords: CT, computed tomography; Cell block; Elemental analysis; Pleural effusion; Silica; Silicosis.

Publication types

Case Reports