SOLITARY MASS IN THE LUNGS OF COAL MINERS

Coal miners with at least 15 years of dust exposure may have a solitary density caused by progressive massive fibrosis (PMF), even when there is little or no nodularity elsewhere in the lungs. The mass may closely resemble a carcinoma, but the correct diagnosis can be made if the typical roentgen features of PMF are present. The characteristic findings are as follows:

1. The lateral border of the mass is flat, often elongated, and parallels the rib cage.

2. The mass is thin in the lateral or oblique projection and is more radiolucent in the frontal projection than a spherical lesion.

3. Characteristic calcifications are present.

4. There are multiple satellite nodules near the mass.

Previous roentgenograms are most helpful and may be virtually diagnostic, if there is evidence that the mass developed by the coalescence of nodules, if the mass decreased in size, if its margin became more sharply defined or if the mass migrated medially.

Careful evaluation of the lung mass according to the above criteria will help prevent unnecessary surgery in this poor risk group.

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