PERITONEAL SILICOSIS

A 73-year-old man with a clinical diagnosis of pulmonary silicosis (lo ng-standing exposure to silica, pulmonary infiltrates, and flu-like sy mptoms) presented to the emergency room with fever, acute biliary coli c, and cholelithiasis. The patient had a 2-year status postchemotherap y with complete remission of hepatic and splenic malignant lymphoma. A t laparotomy we found studding of the undersurface of the diaphragm wi th multiple small dark nodules. Owing to the patient's history of prev iously treated abdominal malignant lymphoma, the lesions were grossly interpreted as abdominal lymphomatosis. The microscopic appearance of the lesions suggested silicotic nodules, which were confirmed by digit al scanning electron microscopy and roentgenographic microanalysis per formed on formalin-fixed, paraffin-embedded tissue. This is an unusual extrapulmonary pattern of peritoneal seeding in silicosis.