PMF occurs as a complication in coal workers pneumoconiosis and silicosis. The chronic form is most common occurring many years after exposure to relatively low levels of dust. Complicated silicosis is also called PMF. PMF commonly affects apical and posterior segments of upper lobes with development of paracicatricial emphysema in adjoining lung. Complications include TB and carcinoma. The incidence of lung cancer is high in pneumoconiosis patients. Hence it is important to differentiate between PMF and lung cancer. Differentiation between PMF and lung cancer is difficult for clinicians as well as radiologist. We report a case of 65 year old patient presenting with breathlessness for two years whose chest X-ray and HRCT lung revealed mass like consolidation in both upper lobes with air bronchogram and volume loss with their lateral surface parallel to lateral chest wall giving angel’s wing appearance. These lesions were hypo intense on T2WI suggestive of PMF rather than neoplastic mass.
