Welder's pneumoconiosis: Diagnostic usefulness of high-resolution computed tomography and ferritin determinations in bronchoalveolar lavage fluid

Objective We assessed the usefulness of high-resolution computed tomography (HRCT) and ferritin determinations in bronchoalveolar lavage (BAL) fluid for diagnosis of welder's pneumoconiosis. Patients and Methods We investigated 11 patients with welder's pneumoconiosis who were 34 to 67 years old and had been welding for 17 to 45 years. Ten patients were current smokers. We performed chest radiography and HRCT, and measured serum ferritin on all 11 patients. We obtained BAL fluid in 9 cases and transbronchial lung biopsy (TBLB) specimens in 7. Ferritin concentrations in BAL fluid were compared with those in welders without pneumoconiosis and other pneumoconiosis cases. Results HRCT revealed small centrilobular nodules in 9 cases, mild fibrotic changes in 3, and emphysematous changes in 3. Serum ferritin concentrations were elevated (>240 ng/ml) in 10 cases. Ferritin concentrations in BAL fluid were higher in welder's pneumoconiosis than in the occupational control group. Conclusion In welder's pneumoconiosis, small centrilobular nodules are frequently seen on HRCT, and ferritin shows elevations in serum and/or BAL fluid. Such ferritin determinations are of value in diagnosis.