Pneumoconiosis differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dushka Riaz, MD
Overview
Pneumoconiosis must be differentiated from other diseases that cause chronic cough and dyspnea.
Differentiating Pneumoconiosis from other Diseases
Pneumoconiosis must be differentiated from other diseases that cause cough and dyspnea.
Differentiating pneumoconiosis from other diseases on the basis of dyspnea and cough
On the basis of cough and chronic dyspnea, pneumoconiosis must be differentiated from lung malignancy, tuberculosis, emphysema, asthma, interstitial lung disease, pneumonia, and sarcoidosis. [1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13] [14] [15] [16] [17] [18] [19] [20] [21] [22]
| Diseases | Clinical manifestations | Para-clinical findings | Gold standard | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Symptoms | Physical examination | |||||||||
| Lab Findings | Imaging | |||||||||
| Chronic Dyspnea | Cough | Fever | Spirometry | Auscultation | Night Sweats | CBC | ABG | Imaging | ||
| Pneumoconiosis | + | + | + | β FEV1/FVC | Wheezing, rhonchi, crackles | + | βWBC | βO2, βCO2 | Massive fibrosis, hilar adenopathy, reticular opacities, pleural plaques | HRCT |
| Lung Malignancy | + | + | – | βVt, βRV | Wheezing, crackles | + | Normal | Normal | Mass lesion, hilar lymphadenopathy | Bronchoscopy |
| Tuberculosis | + | + | + | Restrictive, obstructive, or mixed | Wheezing, rhonchi, crackles | + | βWBC | βO2, βCO2 | Patchy consolidation, nodular opacities | IFN-y assay and acid fast stain |
| Emphysema | + | + | – | β FEV1/FVC | Wheezing | – | Normal | Respiratory alkalosis, Metabolic acidosis | Flat diaphragm | Physical exam, spirometry |
| Asthma | + | + | – | β FEV1/FVC | Wheezing | – | β Eosinophil | Respiratory alkalosis, Metabolic acidosis | Normal | Physical exam, spirometry before and after bronchodilator |
| Interstitial lung diseases | + | + | – | β FEV1/FVC | Wheezing, rhonchi, crackles | +/- | Normal | βO2, βCO2 | Peripheral pulmonary infiltrative opacification | HRCT |
| Sarcoidosis | + | + | – | β FEV1/FVC | Crackles | + | Normal | βO2, βCO2 | Hilar adenopathy | HRCT |
| Pneumonia | + | + | + | Normal | Wheezing, rhonchi, crackles | + | βWBC, neutrophilia | Normal | Lobar consolidation | CXR, CT Scan |
References
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