EXTRATHORACIC EGG-SHELL CALCIFICATIONS IN SILICOSIS

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Abstract
Two cases of extrathoracic egg-shell calcification of lymph nodes in silicosis, each involving the supraclavicular and abdominal nodes in addition to the pulmonary or mediastinal nodes, are reported. Only 3 patients, with similarly calcified abdominal nodes and 1 with supraclavicular involvement have previously been recorded. Retrograde lymphatic drainage due to blockage of the usual lymph channels, followed by the characteristic reaction to silica, appears to be the best explanation for the egg-shell calcification of the abdominal lymph nodes. Lymphatic spread also accounts for the findings in the supraclavicular nodes and possibly the changes in the spleen and liver. Of the 5 patients with abdominal egg-shell calcification so far reported, 3 died of carcinomatosis, and a possible relationship may or may not exist.

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