A possible case of pneumoconiosis in a limestone quarry worker

Background A 43-year-old man presented with wheeze and shortness of breath. He had an occupational history of working in a limestone quarry. Pulmonary function testing revealed a mixed obstructive/restrictive defect. Chest X-ray revealed nodular shadowing throughout both lung fields Methods Subsequent thoracoscopic lung biopsy was performed and histology of the nodules revealed a foreign body granulomatous reaction with numerous fluorescent particles seen under polarized light. There was no evidence of interstitial fibrosis. Results Energy dispersive X-ray analysis (EDXA) scanning confirmed that these particles contained calcium, aluminium and silicon and had a composition consistent with limestone. Conclusions This case demonstrates a possible unusual reaction to inorganic dust particles without resultant fibrosis.