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已发表论文
长期从事采石工作的矽肺患者并发胸腔积液的诊断：一例报告
Authors Zhu X, Wu S, Zeng J, Sun Y, Chen J, Wu X
Received 16 July 2025
Accepted for publication 21 October 2025
Published 15 November 2025 Volume 2025:18 Pages 1447—1455
DOI https://doi.org/10.2147/IMCRJ.S554219
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Professor Thomas E Hutson
Xingxing Zhu,1 Shengjie Wu,2 Jiling Zeng,3 Yahong Sun,1 Jialu Chen,4 Xiaohong Wu5
1Department of Pulmonary and Critical Care Medicine, Haining People’s Hospital, Haining, People’s Republic of China; 2Department of Pharmacy, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 3Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 4Department of Gynaecology, Haining Maternal and Child Health Hospital, Haining, People’s Republic of China; 5Department of Respiratory and Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
Correspondence: Xiaohong Wu, Department of Respiratory and Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3 Qingchun East Road, Shangcheng District, Hangzhou, 310000, People’s Republic of China, Tel +86 13588706901, Email 3192018@zju.edu.cn
Background: Patients affected by silicosis often exhibit clinical symptoms such as dyspnea, chronic cough, sputum production, hemoptysis, and chest pain. Common complications of silicosis include pulmonary tuberculosis, right-sided heart failure, emphysema, and lung cancer. Some of these complications can cause pleural effusion, however, reports that clearly attribute pleural effusion directly to silicosis are uncommon. We report a case of pleural effusion directly caused by silicosis, confirmed by thoracoscopic pleural biopsy and polarized microscopy.
Case Description: We report a case of a 78-year-old man with a history of working in a quarry for over 10 years. He was admitted to our hospital twice due to chest tightness and dyspnea. Both chest computed tomography (CT) scans indicated multiple nodular changes in the lungs, with predominantly right-sided pleural effusion. The results of pleural fluid tests were consistent with exudative effusion. Pleural biopsy specimens obtained by thoracoscopy showed silica particles under polarized light microscopy. Additional tests ruled out heart failure, tumors, and other causes of pleural effusion, based on which a final diagnosis of pleural effusion due to silicosis was made.
Conclusion: This case provides histological proof that silicosis can directly involve the pleura and cause exudative effusion. Furthermore, it highlights the diagnostic value of thoracoscopic pleural biopsy with polarized microscopy in silica-exposed patients with unexplained pleural effusion.
Keywords: silicosis, silica, pleural effusion, thoracoscopy, pleural biopsy
1Department of Pulmonary and Critical Care Medicine, Haining People’s Hospital, Haining, People’s Republic of China; 2Department of Pharmacy, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 3Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 4Department of Gynaecology, Haining Maternal and Child Health Hospital, Haining, People’s Republic of China; 5Department of Respiratory and Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
Correspondence: Xiaohong Wu, Department of Respiratory and Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3 Qingchun East Road, Shangcheng District, Hangzhou, 310000, People’s Republic of China, Tel +86 13588706901, Email 3192018@zju.edu.cn
Background: Patients affected by silicosis often exhibit clinical symptoms such as dyspnea, chronic cough, sputum production, hemoptysis, and chest pain. Common complications of silicosis include pulmonary tuberculosis, right-sided heart failure, emphysema, and lung cancer. Some of these complications can cause pleural effusion, however, reports that clearly attribute pleural effusion directly to silicosis are uncommon. We report a case of pleural effusion directly caused by silicosis, confirmed by thoracoscopic pleural biopsy and polarized microscopy.
Case Description: We report a case of a 78-year-old man with a history of working in a quarry for over 10 years. He was admitted to our hospital twice due to chest tightness and dyspnea. Both chest computed tomography (CT) scans indicated multiple nodular changes in the lungs, with predominantly right-sided pleural effusion. The results of pleural fluid tests were consistent with exudative effusion. Pleural biopsy specimens obtained by thoracoscopy showed silica particles under polarized light microscopy. Additional tests ruled out heart failure, tumors, and other causes of pleural effusion, based on which a final diagnosis of pleural effusion due to silicosis was made.
Conclusion: This case provides histological proof that silicosis can directly involve the pleura and cause exudative effusion. Furthermore, it highlights the diagnostic value of thoracoscopic pleural biopsy with polarized microscopy in silica-exposed patients with unexplained pleural effusion.
Keywords: silicosis, silica, pleural effusion, thoracoscopy, pleural biopsy