Rapidly Fatal Silicosis Among Jewellery Workers Attending a District Medical College of West Bengal, India.

BACKGROUND: Silicosis is a slowly progressive chronic occupational lung disease, developed after a prolong period of exposure to high concentration of silica dust. METHODS: In this longitudinal study, we enrolled old and new silicosis patients (n=19; 8 jewellery polishers, 11 from other occupations) seen at our Pulmonary Medicine Department from June 2009 to December 2012 to document the course of illness as per their occupational exposure. RESULTS: Six of the eight jewellery polishing workers had developed silicosis within five years of exposure, while six of the 11 other workers with other occupational exposure had developed silicosis after exposure of 10 years or more. Mean duration of exposure was significantly less among jewellery polishing workers compared to other workers (3.4 +/- 1.7 versus 9.3 +/- 4.1; p=0.001). Mean duration of illness (months) (14.9 +/- 5.8 versus 28.5 +/- 16.5; p=0.040) were significantly less among the jewellery polishing workers compared to other workers. At the end of the study period, all eight jewellery polishing workers with silicosis had died while four of the 11 patients with other occupational exposure had died. CONCLUSION: Silicosis among jewellery polishing workers was found to be more severe and progressive compared to silicosis due to other occupational exposures, in our study.

Small cell lung carcinoma associated with progressive systemic sclerosis.

ABSTRACT: The association between progressive systemic sclerosis (PSS) and malignancy is uncommon. The possibility of development of small cell carcinoma lung (SCLC), among all the reported lung malignancies in PSS patients is lowest. A fifty-five year old non-smoker female diagnosed as PSS for 1 year presented to our outpatient department with dry cough for 2 months, shortness of breath for the last 1 month and progressive facial and right upper limb oedema for the last 15 days. Chest X-ray showed homogenous opacity in the right upper and mid zones of lung and the obliteration of both costophrenic angles. High resolution computed tomography (CT) of the thorax revealed a right upper lobe lung mass with bilateral minimal pleural effusion and the presence of bilateral reticular opacities, with basal predominance, associated with septal thickening, suggestive of interstitial lung disease of non-specific interstitial pneumonia pattern. CT guided fine needle aspiration cytology (FNAC) from the right upper lobe mass was suggestive of small cell carcinoma. Patient was improved after 6 cycles of chemotherapy with carboplatin and etoposide.