Utility of CT findings on diagnosis of occupational lung disease

IntroductionWe experienced two occupational lung diseases on a different situation in military training. The purpose of this study was to investigate the use of CT images for inhaled pulmonary edema from the standpoint of early diagnosis and assessment of severity.Materials and methodsCase 1: Two soldiers who used the rust proofing sprays and dust removal sprays for the daily maintenance of their arms suffered from severe lung edema. Case 2: Four soldiers suffered from severe dyspnea because they drilled in the field where many smoke canisters were used. We evaluated these patients by clinical symptoms, laboratory data, pulmonary function test, chest X-P and CT images.ResultsCase 1: Their chest CT scan showed bilateral infiltration mainly in the upper lung field. Steroid pulse treatment was used for recovery. Seven days later, their chest X-P showed almost normal. Case 2: Their chest radiographs showed mild infiltrative shadows. Their chest CT scan showed bilateral ground grass attenuation with the peripheral lung spared. They recovered gradually by steroid therapy. Seven days later, mild abnormal shadow was observed in their chest CT images.DiscussionIn the literature, chest CT scan showed diffused ground glass opacities mainly in the upper lung field of inhaled pulmonary edema patients. The peripheral part of the lungs was kept normal excluding the seriously injured cases. These findings are the same as those in our cases. When differential diagnosis was needed, we considered chest CT scan especially useful. The findings of CT scan are useful not only for the diagnosis of inhaled pulmonary edema but also for determining the severity of lung injury.