Silicosis presenting as bilateral hilar lymphadenopathy and lithoptysis

Silicosis is one of the most common occupational lung diseases in the world. It has varied clinical presentation . Silicosis presenting as bilateral hilar lymphadenopathy without any pulmonary nodule is very rare.Only few studies are available describing such a presentation despite the known fact that hilar nodes are the first to be involved in pathogenesis of silicosis. Lithoptysis is a rare medical phenomenon commonly caused by tuberculosis and histoplasmosis. Only few cases of lithoptysis have been reported in patients with silicosis in medical literature. We report a case of silicosis who worked as a ledgeman in quarry fields 9 years back and presented to us with lithoptysis . His imaging study showed bilateral hilar lymphadenopathy with egg shell calcification