Progressive Massive Fibrosis aka Complicated Silicosis. Silicosis is a fibrotic lung disease caused by inhalation of crystalline silica during occupational exposure during mining. Coal workers Pneumoconiosis results from inhalation of a dust that is a mixture of coal, kaolin, mica, and silica. With disease progression, coalescence of the nodules leads to development of progressive massive fibrosis (PMF), also known as complicated silicosis. Seen here bilaterally in the upper lobes and para hilar regions with Calcification (seen in CT!). Mediastinal lymph nodes display the typical eggshell pattern of Calcification! In the lower zones, evidence of emphysematous changes seen along with multiple large bulla! Dr. Devpriyo Pal @drdevrad #Progressive #Massive #Fibrosis #Silicosis #clinical #radiology #CXR #Chest #XRay #labeled #pulmonary