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Br J Ind Med. 1984 February; 41(1): 84–87.
PMCID: PMC1009240

Pulmonary granulomatous reaction: talc pneumoconiosis or chronic sarcoidosis?


A chronic pulmonary granulomatous reaction was associated with an almost identical clinical picture in two patients exposed to talc. In both patients lung biopsy showed the deposition of talc particles and a heavy granulomatous reaction. At the time of diagnosis the Kveim test result was negative in both patients, urinary calcium excretion was normal, and there were no extrapulmonary manifestations and no response to steroid treatment. These findings point against sarcoidosis. The serum angiotensin-converting enzyme level, however, was raised in both patients. It was concluded that the patient who was exposed to talc in the rubber industry had a true talc pneumoconiosis. The other patient, who was exposed to cosmetic talcum powder, suffered from chronic sarcoidosis with talc deposition in the lungs, since an enlarged axillar lymph node containing granulomatous inflammation was discovered after two years' follow up. These cases show that it may be extremely difficult to differentiate between chronic sarcoidosis and talc pneumoconiosis even after careful clinical and histological analysis.

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Selected References

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  • Moskowitz RL. Talc pneumoconiosis: a treated case. Chest. 1970 Jul;58(1):37–41. [PubMed]
  • Nam K, Gracey DR. Pulmonary talcosis from cosmetic talcum powder. JAMA. 1972 Jul 31;221(5):492–493. [PubMed]
  • Wells IP, Dubbins PA, Whimster WF. Pulmonary disease caused by the inhalation of cosmetic talcum powder. Br J Radiol. 1979 Jul;52(619):586–588. [PubMed]
  • Rohl AN, Langer AM, Selikoff IJ, Tordini A, Klimentidis R, Bowes DR, Skinner DL. Consumer talcums and powders: mineral and chemical characterization. J Toxicol Environ Health. 1976 Nov;2(2):255–284. [PubMed]
  • Kleinfeld M, Messite J, Zaki MH. Mortality experiences among talc workers: a follow-up study. J Occup Med. 1974 May;16(5):345–349. [PubMed]
  • Lieberman J, Nosal A, Schlessner A, Sastre-Foken A. Serum angiotensin-converting enzyme for diagnosis and therapeutic evaluation of sarcoidosis. Am Rev Respir Dis. 1979 Aug;120(2):329–335. [PubMed]
  • Farber HW, Mathers JA, Jr, Glauser FL. Gallium scans and serum angiotensin converting enzyme levels in talc granulomatosis and lymphocytic interstitial pneumonitis. South Med J. 1980 Dec;73(12):1663–1667. [PubMed]

Articles from British Journal of Industrial Medicine are provided here courtesy of BMJ Group