A FATAL case of disabling progressive pneumoconiosis in a soft-coal worker, following removal from further exposure to the etiologic dust, is here presented. Evidence of pulmonary nodulation was lacking in serial roentgenograms of the chest. Massive conglomerate lesions and cavitation without coexisting tuberculosis were demonstrated.
O. L. W., a white soft-coal worker, was 57 years old at the time of his death. He had worked under ground for 29 years. The patient was first seen in this clinic on June 22, 1949. At that time his chief complaints were shortness of breath, cough, and pain in the chest. He first experienced these symptoms during the early part of 1943. In October of that year he was studied in one of the local hospitals by another physician. X-ray examination of the chest at that time (Fig. 1) revealed diffuse symmetrical linear changes throughout both lung fields and emphysema. The patient was