대한흉부영상의학회 Weekly Chest Cases

Courtesy of Gong Yong Jin / Chonbuk National University Medical School and Hospital
Age/Sex 47 / M
Chief ComplaintDyspnea (Onset: 2 hours later after cleaning up a greenhouse), No fever

initial chest PA

Diagnosis: Chemical pneumonitis induced by nitric acid inhalation
Radiologic Findings: There is ground glass opacity with multifocal nodular opacity in both lungs on chest X-ray. On chest CT, multifocal patchy consolidation with bilateral diffuse ground glass opacity was shown. There is no pleural effusion.
Brief Review: He is a cleaning man and cleaned up greenhouse during 1 hour after 60% HNO3 spillage. Chemical pneumonitis usually occurs after occupational exposure and inhalation of various noxious gases, fumes and chemical compounds. However, chemical pneumonitis induced by nitric acid inhalation is a rare.
The chest X-ray showed multifocal patchy consolidation and diffuse interstitial opacities on whole lung fields. CT findings of this disease include bilateral perihilar consolidation and ground-glass attenuation, suggesting acute alveolar injury, delayed bronchiolitis obliterans, and bronchiectasis. Eighth days later after conservative management that included an oxygen supply with steroid therapy in the intensive care unit, his symptoms were improved and the hypoxemia was corrected. At the 8th day, the chest radiograph became normal.
References: 1. White CS, Templeton PA. Chemical pneumonitis. Radiol Clin
North Am 1992;30:1231-1243
2. McLoud TC. Occupational lung disease. Radiol Clin North Am
1991;29:931-941
Keywords: Lung, Inhalation and aspiration disease,

대한흉부영상의학회 Korean Society of Thoracic Radiology