A solitary pulmonary nodule in a former glass blower mimicking a primary lung adenocarcinoma

Abstract

Introduction: Inhalation of silicon dioxide causes silicosis, a condition that may occur in various industries and work settings. Radiologic findings typically show numerous nodular opacities, while solitary pulmonary nodules are atypical for silicosis.

Presentation of case: A 68-year-old woman, a former glassblower, presented with a left solitary pulmonary nodule (13 mm) on chest computed tomography. The nodule enlarged to 23 mm over 6 months, exhibiting an irregular shape, spiculated margin, and rapid growth with a doubling time of 186.4 days. She underwent a left upper lobectomy with a suspicion of lung cancer. The histopathological findings revealed peribronchial lymphocytic infiltration and granulomatous-like structures containing multinucleated giant cells and phagocytic crystalline foreign bodies. These findings were consistent with a foreign body reaction to the glass fragments.

Discussion: Inhaled glass fragments may present as a solitary pulmonary nodule after the retirement of a glass blower. Its behavior and radiological features mimicked a primary lung adenocarcinoma.

Conclusion: Solitary pulmonary nodules due to inhaled glass fragments may mimic a primary lung adenocarcinoma. A definitive diagnosis requires a histological examination in this rare condition.

Keywords: Silicon dioxide; Silicosis; Solitary pulmonary nodule.