In silicosis, which radiographic finding is typical in the hilar and mediastinal lymph nodes?

In silicosis, which radiographic finding is typical in the hilar and mediastinal lymph nodes?

• A. Pleural plaques
• B. Eggshell calcifications
• C. Diffuse nodular opacities without calcifications
• D. Cavitary lesions

Answer: (B)

Eggshell calcifications of the hilar and mediastinal lymph nodes are a classic radiographic finding in silicosis. Inhaled silica particles are taken up by macrophages, triggering a fibrotic response that often involves the lymph nodes. Calcification tends to begin at the periphery of these enlarged nodes, producing a thin calcified rim seen on chest X‑rays. This peripheral or “eggshell” pattern is relatively characteristic for silica exposure and pneumoconiosis. Other findings don’t fit as well. Pleural plaques point to asbestos exposure rather than silica and appear on the pleura, not the lymph nodes. Diffuse nodular opacities in the lungs describe parenchymal involvement rather than nodal calcification. Cavitary lesions are more typical of infections like tuberculosis or certain fungal diseases or malignancy, not the nodal calcifications seen in silicosis.

Eggshell calcifications of the hilar and mediastinal lymph nodes are a classic radiographic finding in silicosis. Inhaled silica particles are taken up by macrophages, triggering a fibrotic response that often involves the lymph nodes. Calcification tends to begin at the periphery of these enlarged nodes, producing a thin calcified rim seen on chest X‑rays. This peripheral or “eggshell” pattern is relatively characteristic for silica exposure and pneumoconiosis.

Other findings don’t fit as well. Pleural plaques point to asbestos exposure rather than silica and appear on the pleura, not the lymph nodes. Diffuse nodular opacities in the lungs describe parenchymal involvement rather than nodal calcification. Cavitary lesions are more typical of infections like tuberculosis or certain fungal diseases or malignancy, not the nodal calcifications seen in silicosis.