Objective To analyze the first case of occupational hard metal lung disease (OHMLD) diagnosed in Hunan Province and to provide reference for making corresponding diagnostic criteria.

Methods The occupational history, clinical manifestations, radiological changes, and pathological data of a patient with confirmed OHMLD were presented, and relevant literatures were reviewed.

Results The main clinical symptoms of the OHMLD patient included dry cough, dyspnea, and gasp; the pulmonary function testing results showed a restrictive ventilatory functional disturbance and diffusion dysfunction; the CT scans demonstrated diffuse bilateral ground-glass attenuations and fibrous strips. The lung biopsy specimens showed congregations of alveolar macrophages and numerous large multinucleated histiocytes in alveolar spaces, which were the typical presentation of giant cell interstitial pneumonia (GIP). The results indicated that glucocorticoid treatment was effective for OHMLD.

Conclusion OHMLD shows no specific clinical manifestations, and GIP is the major pathognomonic change. A diagnosis of OHMLD could be well achieved based on the clinical diagnosis of GIP and the occupational history of hard metal exposure.