Chest X-ray. A. Pneumonitis or pulmonary tuberculosis in both upper lobes. A lung mass lesion in the right upper lobe was ruled out. B. Pneumoconiosis such as silicosis with progressive massive fibrosis (PMF). Slightly decreased densities around PMF were present since January 2012. A differential diagnosis for lung cancer, which is rarely considered, was performed. C. Pneumothorax, right. Underlying complicated pneumoconiosis, progressive massive fibrosis. HRCT. D. PMF, subpleural, and centrilobular silicotic nodules (arrows) are seen at both lung and pseudoplaque formation (arrow at pleural area) in the right lung.