Polishing surgical metal pieces, granulomatosis and mineralogical analysis

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Mickaël Catinon
C. Chemarin
E. Roux
C. Cavalin
P.-A. Rosental
F. Thivolet-Bejui
M. Vincent


Sarcoid-like granulomatous disease, Mineralogical analysis, Occupational disease


This report describes the case of a 44-year-old man with pulmonary nodules whose histological analysis initially suggested tuberculosis. The Mycobacterium tuberculosis (MT) culture was negative and a questionnaire revealed a professional activity of brushing and polishing surgical instruments without any protection for 7 years.  A mineralogical analysis by optical and electron microscopy was performed on both a healthy lung tissue biopsy and a lung nodule in a paraffin block. Electron microscopy analysis revealed the presence of metal particles (iron oxide, titanium oxide, aluminum oxide and steel) in both samples. This study suggests that mineralogical analysis combined with a questionnaire on dust exposure could help redirect the diagnosis of a dust-related disease. 


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