Coal Worker’s Pneumoconiosis Presenting as Miliary Opacities: A Diagnostic Dilemma

A 54-year-old male, with a smoking history of 10 pack-years and employed as a coal mine worker for 16 years, presented with complaints of intermittent cough for three years, dyspnoea on exertion Modified Medical Research Council (mMRC) score of II to III since one year, and a history of loss of appetite and weight loss around 10 kilograms over a period of six months. The patient denied any history of systemic co-morbidities. On general examination, the patient was conscious and oriented to time place and person and was vitally stable. On systemic examination, palpation findings within normal limits, percussion revealed resonant notes over all lung fields, and auscultation demonstrated reduced breath sounds in the right infraclavicular region.