Coffee worker's lung. A new example of extrinsic allergic alveolitis.

The morphological changes that may occur in the group of diseases that were labelled 'idiopathic chronic interstitial fibrosis of the lung', better named 'chronic diffuse fibrosing alveolitis', are by now well known. In the majority of cases the aetiology remains obscure, but it has become increasingly clear that in many cases (particularly when granulomatous lesions are present) the changes that occur are the result of an antigenantibody reaction provoked by inhalation of some form of organic dust or some component of a fungus, functioning as an antigen. Emanuel, Wenzel, Bowerman, and Lawton (1964) and Seal, Hapke, Thomas, Meek, and Hayes (1968) have pointed out that the ifeatures suggestive of extrinsic allergic alveolitis are less obvious as the d-isease becomes chronic, and the picture seen in the later stages cannot be distinguished from those of the so-called idiopathic forms of the disease. Therefore in every case of diffuse fibrosis of the lungs a detailed inquiry must be made into the exact occupation of the patient and also into any possible significant aetiological environmental factor. Although many of these factors are now known, probably there are a numrber of substances which may initiate diffuse pulmonary diseases. The purpose of this paper is to describe a patient, sensitized by coffee bean dust, on whom immunopathological investigations as well as histological studies have been performed.