A 58-year-old underground coal miner with 30 years of occupational exposure presents with progressive dyspnea and nonproductive cough. Vital signs show HR 92/min, RR 22/min, BP 138/86 mmHg, SpO2 88% on room air. Chest radiograph demonstrates diffuse upper lobe nodular opacities with eggshell hilar lymphadenopathy. PFTs reveal reduced FVC and FEV1 with normal FEV1/FVC ratio. He denies fever, weight loss, and has no history of pleural plaques or bird exposure. Which diagnosis best explains these findings?
- A)Coal workers pneumoconiosisGABARITO
- B)Silicosis
- C)Idiopathic pulmonary fibrosis
- D)Asbestosis
- E)Hypersensitivity pneumonitis
Explicação
Coal workers pneumoconiosis is correct. Long term coal dust exposure in a miner with upper lobe nodular opacities is classic. Unlike asbestosis, pleural plaques are absent, and unlike hypersensitivity pneumonitis, there is no clear organic antigen trigger. Ver explicação completa e trilha adaptativa →