271
Views
45
CrossRef citations to date
0
Altmetric
Original Article

Pathologic Spectrum and Lung Dust Burden in Giant Cell Interstitial Pneumonia (Hard Metal Disease/Cobalt Pneumonitis): Review of 100 Cases

, , &
Pages 51-70 | Published online: 07 Aug 2010
 

Abstract

Hard metal disease (HMD), the interstitial lung disease caused by dusts in the cemented tungsten carbide (WC) industry, has been attributed to cobalt. The rare histologic pattern of giant cell interstitial pneumonia (GIP) is characteristic in HMD. The authors reviewed the history of HMD and 100 cases of HMD that they have seen over 5 decades. GIP was proven in 59; analysis of the lung inorganic particle burden by scanning electron microscopy and energy-dispersive x-ray spectroscopy confirmed HMD in the other 41. Cases have been diagnosed by bronchoalveolar lavage, lung biopsy, and autopsy. Histopathology findings range from focal peribronchiolar inflammation to diffuse interstitial fibrosis and honeycombing. GIP cases in the WC industry reveal elevated concentrations of tungsten in all, but cobalt was detected in only 6 (∼10%). Of the 746 diverse cases in the authors' analytical database, almost all cases with the highest tungsten concentration showed GIP. This study confirms that GIP is effectively pathognomonic for HMD.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.