We had recently a young patient (under forty), without alfa 1antitripsin deficiency, with quite severe emphysema. He had exposure to carborundum without any kind of protection for fifteen years, besides being a heavy smoker for twenty years. He had a positive TB skin test, but repeatedly negative cultures. He had also some lung fibrosis and nodules, that fulfilled all criteria for silicosis, but his lung function was compatible with pure obstructive disease, without response to broncodilators, low DLCO and hyperinflation. Do anybody else have such cases?