Abstract
Pneumoconiosis, caused by inhaling mineral dust, remains a significant occupational disease, despite a declining incidence. Coal workers' pneumoconiosis (CWP), a common subtype, varies in presentation from simple to complicated forms. Differential diagnosis is crucial, especially when CWP manifests as lung masses mimicking malignancy. We present a case of CWP in a 75-year-old female with a history of breast cancer, initially suspected of lung cancer due to an incidental mass on chest radiography. Clinical examination, laboratory tests, chest tomography, and biopsy were conducted. The patient, with a history of biomass fuel exposure, presented with a left upper lung mass, initially thought to be lung cancer. Biopsy-induced hemopneumothorax led to intensive care admission. Histopathology confirmed CWP and conservative management resulted in recovery. Imaging revealed a solid mass in the left upper lung with lymphadenopathy. Histopathology showed carbon-laden macrophages and anthracosis, consistent with CWP. Imaging modalities, including MRI and FDG-PET/CT, aid in differentiating CWP from cancer. CWP, mimicking lung cancer, underscores the importance of accurate diagnosis. Imaging features, including nodules with calcifications, guide diagnosis. MRI and FDG-PET/CT offer valuable insights, albeit with limitations, emphasizing the need for judicious use based on clinical suspicion.