OBJECTIVETo evaluate imaging of high-resolution computed tomography (HRCT) for nodules of cadaveric lungs of coal workers' or coal workers with coal workers' pneumoconiosis (CWP) and to determine types of small nodules of CWP and dust speckle based on CT-pathologic correlation.

METHODSThirty-two entire lung specimens were available from autopsy of the patients with CWP and coal workers occupationally exposed to coal dusts. They comprised 25 workers without CWP, 3 patients with 0+ stage and 4 patients with I stage. Thirty-two lung specimens were inflated and fixed by Heitzman's method, and underwent coronal single slice computed tomography (SSCT)/multi-slice computed tomography (MSCT) and HRCT scans. Gross specimens section (50 approximately 100 microm of slice thickness) and histological section (5 approximately 8 microm of slice thickness) were performed on seventeen pieces of 10 mm-thickness slices of lung specimen in thirteen cases. The nodules were divided into round, ill defined and stellate-shaped, and their distributions and relationships with pulmonary lobule were analyzed.

RESULTSThe findings were as follows (1) 14 cases without CWP and 18 cases with CWP (including 5 cases with I stage 11 cases with II stage and 2 cases with III stage) were diagnosed by pathology. (2) Nodules were displayed on HRCT in 32 cases, among which 29 cases were verified by pathology. There was no significant difference between HRCT and pathology (chi2 = 0.5, 0.25 < P < 0.5). (3) Nodules of CWP on HRCT included well-defined round nodules, ill defined nodules and stellate-shape nodules. Twelve of fourteen round nodules on HRCT were pathologically typical ones. Twenty-six ill defined nodules on HRCT included 14 atypical ones, 11 dust macules and 1 typical one by pathology. Six dust macules and 3 atypical nodules were found by pathology in nine stellate-shape nodules on HRCT. (4) HRCT accurately displayed nodular distributions including nodules adjacent to small artery, thickened septa and subpleural regions.

CONCLUSIONHRCT could display typical, atypical nodules and some dust macules presenting pathologic changes, as well as relationship between nodules and structure of pulmonary lobule.