Talc is a hydrated magnesium silicate used in the chemical, ceramic, cosmetic, leather, paper and building industries. Interstitial lung disease - talcosis - due to exclusive talc inhalation is a rare form of pneumoconiosis. More often, pulmonary disease due to talc is encountered after intravenous administration of talc during drug abuse. Talc can contain asbestos or quartz particles which induce asbestosis or silicosis. Here we present a case report about a worker who was exposed to talcum during his work in tire manufacturing. During his lifetime an occupational disease was not recognised. The deceased had been forwarded to cremation; the legally prescribed second inspection of the corpse induced the suspicion of an occupational disease and an autopsy was ordered. The autopsy revealed a lung fibrosis with honeycomb lung alterations and under polarised light a massive burden with birefringed crystalline particles could be visualised. Light and electron microscopic lung dust analyses could exclude an elevated asbestos lung burden. The element analysis of foreign body material in lung tissue confirmed its chemical composition of magnesium and silicon which was consistent with talc. Based on the pathological and mineralogical findings, the confirmed occupational exposure towards talc and, due to the exclusion of other possible causes (asbestos, quartz), the diagnose of a talc-induced interstitial lung fibrosis - talcosis - was established. This case emphasises the importance of pathological-anatomic examinations in combination with lung dust analysis to reveal occupational exposure as a cause of an interstitial lung disease.
Talc is a hydrated magnesium silicate used in the chemical, ceramic, cosmetic, leather, paper and building industries. Interstitial lung disease - talcosis - due to exclusive talc inhalation is a rare form of pneumoconiosis. More often, pulmonary disease due to talc is encountered after intravenous administration of talc during drug abuse. Talc can contain asbestos or quartz particles which induce asbestosis or silicosis. Here we present a case report about a worker who was exposed to talcum during his work in tire manufacturing. During his lifetime an occupational disease was not recognised. The deceased had been forwarded to cremation; the legally prescribed second inspection of the corpse induced the suspicion of an occupational disease and an autopsy was ordered. The autopsy revealed a lung fibrosis with honeycomb lung alterations and under polarised light a massive burden with birefringed crystalline particles could be visualised. Light and electron microscopic lung dust analyses could exclude an elevated asbestos lung burden. The element analysis of foreign body material in lung tissue confirmed its chemical composition of magnesium and silicon which was consistent with talc. Based on the pathological and mineralogical findings, the confirmed occupational exposure towards talc and, due to the exclusion of other possible causes (asbestos, quartz), the diagnose of a talc-induced interstitial lung fibrosis - talcosis - was established. This case emphasises the importance of pathological-anatomic examinations in combination with lung dust analysis to reveal occupational exposure as a cause of an interstitial lung disease.