[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-437009-105":59,"doc-detail-437009-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","silicosis-diagnosed-using-transbronchial-lung-biopsy-the-pivotal-role-of-occupational-history","Silicosis Diagnosed Using Transbronchial Lung Biopsy: The Pivotal Role of Occupational History","","Pulmonary silicosis is an underrecognized, preventable occupational lung disease driven by chronic inhalation of crystalline silica dust, yet it is often mistaken for tuberculosis in TB-endemic settings. A 63-year-old man with upper gastrointestinal bleeding had incidental reticulonodular opacities and no respiratory complaints, prompting an extensive TB work-up. Only a delayed occupational history uncovered three decades of unprotected mosaic tiling, shifting suspicion toward silicosis. High-resolution CT and transbronchial lung biopsy confirmed the diagnosis, though his course was later complicated by obstructive uropathy and sepsis, emphasizing radiologic overlap pitfalls and the need for occupational exposure history.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/silicosis-diagnosed-using-transbronchial-lung-biopsy-the-pivotal-role-of-occupational-history/437009/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/silicosis-diagnosed-using-transbronchial-lung-biopsy-the-pivotal-role-of-occupational-history/437009.png","ImageObject",300,407,{"name":92,"@type":93},"Cipher","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why was pulmonary silicosis initially overlooked in this case?","Question",{"text":113,"@type":114},"Incidental reticulonodular opacities in a TB-endemic setting mimicked pulmonary tuberculosis, and the patient lacked cough or other respiratory symptoms. The occupational exposure history was only elicited later, delaying consideration of silicosis.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What imaging and clinical findings prompted a tuberculosis work-up?",{"text":118,"@type":114},"A chest radiograph on admission showed bilateral diffuse reticulonodular opacities, mainly in the upper and mid lung zones, without cavitation or pleural effusion. This pattern raised concern for pulmonary TB despite nonspecific features and stable exam findings.",{"name":120,"@type":111,"acceptedAnswer":121},"How was the diagnosis ultimately confirmed?",{"text":122,"@type":114},"Negative results from sputum AFB testing, GeneXpert, mycobacterial culture, and interferon-gamma release assay reduced support for TB. High-resolution CT followed by transbronchial lung biopsy confirmed silicosis, after occupational history revealed long-term unprotected silica exposure.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},437009,1790736744,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":52,"preview_page_count":4},687208528416,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Clinical Case Reports  \nCASE REPORT  OPEN ACCESS   \nSilicosis Diagnosed Using Transbronchial Lung Biopsy: The Pivotal Role of Occupational History  \nBoon Hau Ng1  | Nor Safiqah Sharil2 | Hsueh Jing Low3 | Nik Nuratiqah Nik Abeed1 | Badrul Iskandar Abdul Wahab4 | Rose Azzlinda Osman1 | Andrea Yu-Lin Ban1  \n1Respiratory Unit, Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, Kuala  \nLumpur, Malaysia | 2Internal Medical Unit, Faculty of Medicine and Health Science, Universiti Sains Islam Malaysia, Nilai, Negeri Sembilan, Malaysia | 3Department of Anaesthesiology and Critical Care, Faculty of Medicine, Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia | 4Department of Diagnostic Laboratory Services, Faculty of Medicine, Universiti Kebangsaan Malaysia, Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia  \nCorrespondence: Andrea Yu-Lin Ban ([andreaban@gmail.com](andreaban@gmail.com))  \nReceived: 8 July 2025 | Revised: 11 November 2025 | Accepted: 21 December 2025  \nKeywords: chest radiograph | occupational history | reticulonodular opacities | silicosis | transbronchial lung biopsy  \nABSTRACT  \nPulmonary silicosis, a preventable occupational lung disease caused by chronic inhalation of crystalline silica dust in industries like construction, mining, and stone masonry, remains underdiagnosed in TB-endemic regions due to overlapping clinical and radiological features. A 63-year-old man presented with upper gastrointestinal bleeding, but a silent lung abnormality stole the clinical spotlight. In a TB-endemic setting, incidental reticulonodular opacities triggered a full tuberculosis work-up, even in the absence of cough or respiratory symptoms. Yet it was only after a delayed occupational history revealed three decades of unprotected mosaic tiling that silicosis was considered. High-resolution CT and transbronchial lung biopsy later confirmed the diagnosis, but not before the patient's course was complicated by obstructive uropathy and sepsis. This case highlights the diagnostic pitfalls of radiologic overlap between silicosis and tuberculosis, as well as the crucial role of occupational exposure history in reaching the correct diagnosis.  \n1 | Introduction  \nPulmonary silicosis is an occupational lung disease resulting from the chronic inhalation of crystalline silica dust, typically affecting individuals in industries such as construction, mining, and stone masonry. Despite being a preventable condition, silicosis remains underdiagnosed, particularly in regions where TB is endemic, due to overlapping clinical and radiological features [1]. Patients with silicosis may present with minimal or no respiratory symptoms, and imaging findings such as reticulonodular infiltrates or upper lobe predominance often mimic pulmonary tuberculosis [2]. In such contexts, there is a high risk of misdiagnosis, which may lead to inappropriate treatment and delayed definitive care.  \nWe report an elderly man presenting with upper gastrointestinal bleeding and incidental bilateral pulmonary opacities, initially  \npresumed to be tuberculosis, but later diagnosed as silicosis after a delayed occupational history revealed chronic silica exposure and histopathology confirmed the diagnosis.  \n2 | Case History/Examination  \nA 63-year-old man was admitted with a 6-day history of melaena, accompanied by dizziness and lethargy. He had been self-medicating intermittently with over-the-counter analgesics. On examination, he appeared pale, with investigations revealing severe anemia (Hb 4 g/dL) (normal range: 13.5–17.5 g/ dL) and hypoalbuminemia. Urgent esophagogastroduodenoscopy showed a prepyloric Forrest 2B ulcer with an adherent clot and pangastritis, for which adrenaline injection and haemoclip application were performed. He received a total of five  \nThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, d","cbCaivupIvNPxRCd","https://ap.wps.com/l/cbCaivupIvNPxRCd","pdf",593432,"English","# Introduction\n# Case History/Examination\n# Differential Diagnosis, Investigations, and Treatment\n# Key Clinical Message","[{\"question\":\"Why was pulmonary silicosis initially overlooked in this case?\",\"answer\":\"Incidental reticulonodular opacities in a TB-endemic setting mimicked pulmonary tuberculosis, and the patient lacked cough or other respiratory symptoms. The occupational exposure history was only elicited later, delaying consideration of silicosis.\"},{\"question\":\"What imaging and clinical findings prompted a tuberculosis work-up?\",\"answer\":\"A chest radiograph on admission showed bilateral diffuse reticulonodular opacities, mainly in the upper and mid lung zones, without cavitation or pleural effusion. This pattern raised concern for pulmonary TB despite nonspecific features and stable exam findings.\"},{\"question\":\"How was the diagnosis ultimately confirmed?\",\"answer\":\"Negative results from sputum AFB testing, GeneXpert, mycobacterial culture, and interferon-gamma release assay reduced support for TB. High-resolution CT followed by transbronchial lung biopsy confirmed silicosis, after occupational history revealed long-term unprotected silica exposure.\"}]","Silicosis Diagnosed Using Transbronchial Lung Biopsy: The Pivotal Role of Occupational History | PDF",1790679809]