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Annals of the American Thoracic Society Sep 2022
Topics: Anthracosilicosis; Coal; Coal Mining; Humans; Pneumoconiosis; Silicon Dioxide
PubMed: 36048122
DOI: 10.1513/AnnalsATS.202206-528ED -
Indian Journal of Occupational and... 2015Nonoccupational anthracosis and silicosis has been reported from various parts of the world including Ladakh in Jammu and Kashmir, India; however, anthracosilicosis has...
BACKGROUND
Nonoccupational anthracosis and silicosis has been reported from various parts of the world including Ladakh in Jammu and Kashmir, India; however, anthracosilicosis has only been reported in industrial workers till date.
MATERIALS AND METHODS
Six cases from the Ladakh region in Jammu and Kashmir, India with similar clinico-radiological-pathological features, i.e., anthracosilicosis/anthracofibrosis have been analyzed. Of these, four were analyzed retrospectively and two prospectively.
RESULT
All the patients were homemakers and resided in Ladakh in Jammu and Kashmir, India since birth with an age range of 42-62 years and an average age of 56 years. Their average duration of symptoms was 4 years. Spirometry showed small and/or large airway disease in 5/6 cases. On computed tomography (CT), 4/6 cases showed progressive massive fibrosis (PMF) with calcified mediastinal lymph nodes. There were random or centrilobular nodules in all the six cases. Bronchoscopy in 5/6 cases showed multiple anthracotic pigments with narrowing and distortion of the bronchus (anthracofibrosis). Malignancy was suspected clinico-radiologically in four cases and pathologically in two cases. On histopathology, anthracosis was demonstrated in all and silicosis in three cases.
CONCLUSION
Anthracosilicosis can occur due to environmental exposure. Ladakh in Jammu and Kashmir, India is the only place across the globe with unique environmental features having the presence of both free silica and biomass fuel. The disease was observed predominantly in older women. Awareness would prevent unnecessary investigation for malignancy. Treatment with the bronchodilator is useful as it has evidence of airway disease. Finally, environmental measures and a proper study need to be undertaken for knowing the relative role of silica versus soot in causing the lung disease and preventing this irreversible condition.
PubMed: 26957815
DOI: 10.4103/0019-5278.173995 -
International Journal of Surgery Case... 2018Lymph node metastasis is one of the most important prognostic factors in gastric cancer and precise assessment of nodal status facilitates optimal therapeutic decisions....
INTRODUCTION
Lymph node metastasis is one of the most important prognostic factors in gastric cancer and precise assessment of nodal status facilitates optimal therapeutic decisions. Many diagnostic modalities including endoscopic ultrasound (EUS), computed tomography (CT), and sometimes, positron emission tomography (PET) have been utilized to improve diagnostic accuracy in detecting metastatic lymph nodes; however, their accuracy remains unsatisfactory.
PRESENTATION OF CASE
We report a case of a 73-year old male patient who was erroneously diagnosed with stage IV gastric cancer due to the distant nodal metastasis from early gastric cancer lesion during the initial staging process. However, surgical exploration revealed an anthracosilicosis-associated lymphadenopathy that mimicked extensive distant nodal metastasis in the preoperative CT and PET-CT scans. The patient was finally diagnosed with stage I gastric cancer confined to the mucosa without nodal metastasis.
DISCUSSION
We report a rare case of gastric cancer concurrent extensive nodal involvement of anthracosilicosis mimicking metastatic nodal disease in the imaging studies. This case implies that PET-CT scan for clinical staging is not specific enough to clearly delineate malignant lesions, causing a diagnostic dilemma.
CONCLUSION
When the characteristics of the primary tumor is poorly correlated to the findings of imaging studies, surgical exploration can be a viable option for a definitive diagnosis before making a hasty decision based only upon the diagnostic imaging results.
PubMed: 30219658
DOI: 10.1016/j.ijscr.2018.08.055 -
Journal of Cardiothoracic Surgery Aug 2023Although thoracic surgeons occasionally encounter dense adhesions of interlobar lymph node anthracosilicosis with the pulmonary artery, adhesiolysis may be challenging....
BACKGROUND
Although thoracic surgeons occasionally encounter dense adhesions of interlobar lymph node anthracosilicosis with the pulmonary artery, adhesiolysis may be challenging. Besides, characteristic microscopic features of the adherent lesion remain limited.
CASE PRESENTATION
During a thoracoscopic right upper lobectomy of a patient with stage IA3 primary lung adenocarcinoma, several interlobar lymph nodes adhered to the posterior ascending branch of the pulmonary artery to the right upper lobe were noted. After an unplanned conversion to a thoracotomy to avoid massive bleeding, the pulmonary artery branch was safely isolated. Microscopic examination revealed lymph node anthracosilicosis proximal to the peripheral pulmonary artery wall, with granulomatous inflammation. The adventitial stroma of the pulmonary artery developed into dense and borderless fibrous tissue with dust-laden macrophages.
CONCLUSIONS
Our pathological findings on lymph node anthracosilicosis provide substantial evidence that adhesions between lymph nodes and the pulmonary artery walls may develop into dense and borderless fibrous tissue. This finding would remind thoracic surgeons that adhesiolysis could cause injury to the pulmonary artery.
Topics: Humans; Pulmonary Artery; Anthracosilicosis; Tissue Adhesions; Lymph Nodes; Lung Neoplasms
PubMed: 37605209
DOI: 10.1186/s13019-023-02348-5 -
Journal of Occupational and... Jan 2015To characterize exposure histories and respiratory disease among surface coal miners identified with progressive massive fibrosis from a 2010 to 2011 pneumoconiosis...
OBJECTIVE
To characterize exposure histories and respiratory disease among surface coal miners identified with progressive massive fibrosis from a 2010 to 2011 pneumoconiosis survey.
METHODS
Job history, tenure, and radiograph interpretations were verified. Previous radiographs were reviewed when available. Telephone follow-up sought additional work and medical history information.
RESULTS
Among eight miners who worked as drill operators or blasters for most of their tenure (median, 35.5 years), two reported poor dust control practices, working in visible dust clouds as recently as 2012. Chest radiographs progressed to progressive massive fibrosis in as few as 11 years. One miner's lung biopsy demonstrated fibrosis and interstitial accumulation of macrophages containing abundant silica, aluminum silicate, and titanium dust particles.
CONCLUSIONS
Overexposure to respirable silica resulted in progressive massive fibrosis among current surface coal miners with no underground mining tenure. Inadequate dust control during drilling/blasting is likely an important etiologic factor.
Topics: Anthracosilicosis; Coal Mining; Humans; Interviews as Topic; Lung Neoplasms; Male; Middle Aged; Occupational Exposure; Occupations; Pulmonary Fibrosis; Radiography
PubMed: 25563541
DOI: 10.1097/JOM.0000000000000302 -
The International Journal of... Jul 2017Diseases associated with coal mine dust continue to affect coal miners. Elucidation of initial pathological changes as a precursor of coal dust-related diffuse fibrosis...
BACKGROUND
Diseases associated with coal mine dust continue to affect coal miners. Elucidation of initial pathological changes as a precursor of coal dust-related diffuse fibrosis and emphysema, may have a role in treatment and prevention.
OBJECTIVE
To identify the precursor of dust-related diffuse fibrosis and emphysema.
METHODS
Birefringent silica/silicate particles were counted by standard microscope under polarized light in the alveolar macrophages and fibrous tissue in 25 consecutive autopsy cases of complicated coal worker's pneumoconiosis and in 21 patients with tobacco-related respiratory bronchiolitis.
RESULTS
Coal miners had 331 birefringent particles/high power field while smokers had 4 (p<0.001). Every coal miner had intra-alveolar macrophages with silica/silicate particles and interstitial fibrosis ranging from minimal to extreme. All coal miners, including those who never smoked, had emphysema. Fibrotic septa of centrilobular emphysema contained numerous silica/silicate particles while only a few were present in adjacent normal lung tissue. In coal miners who smoked, tobacco-associated interstitial fibrosis was replaced by fibrosis caused by silica/silicate particles.
CONCLUSION
The presence of silica/silicate particles and anthracotic pigment-laden macrophages inside the alveoli with various degrees of interstitial fibrosis indicated a new disease: coal mine dust desquamative chronic interstitial pneumonia, a precursor of both dust-related diffuse fibrosis and emphysema. In studied coal miners, fibrosis caused by smoking is insignificant in comparison with fibrosis caused by silica/silicate particles. Counting birefringent particles in the macrophages from bronchioalveolar lavage may help detect coal mine dust desquamative chronic interstitial pneumonia, and may initiate early therapy and preventive measures.
Topics: Adult; Aged; Aged, 80 and over; Coal; Coal Mining; Dust; Emphysema; Humans; Lung; Lung Diseases, Interstitial; Macrophages, Alveolar; Middle Aged; Silicates; Silicon Dioxide; Smoking
PubMed: 28689212
DOI: 10.15171/ijoem.2017.1066 -
Canadian Respiratory Journal 2016Background. Silicoanthracosis is a pneumoconiosis due to occupational inhalation of silica and carbon dusts. Clinically, it can be associated with vasculitis or...
Background. Silicoanthracosis is a pneumoconiosis due to occupational inhalation of silica and carbon dusts. Clinically, it can be associated with vasculitis or rheumatoid arthritis. In association with these diseases, silicoanthracosis can present within the lung with multiple pulmonary nodules which, as a differential diagnosis, can mimic metastatic disease or multiple abscesses. Case Presentation. We present the case of a 62-year old former pit worker with pulmonary nodules, chondrocalcinosis due to calcium pyrophosphate deposition (CPPD), and a history of renal cancer. Within a short period of time, pulmonary nodules grew rapidly. Thoracoscopically, the resected lung specimen revealed silicoanthracosis associated with small-to-medium-size vasculitis in the presence of antineutrophil cytoplasmatic autoantibodies (c-ANCA). Conclusion. Pulmonary silicoanthracotic lesions on the base of ANCA-associated vasculitis and CPPD arthritis can rapidly grow. A mutual correlation between silicoanthracosis, ANCA-associated vasculitis, and CPPD seems possible. Apart from this, consideration of metastatic disease should be obligatory in patients with a history of cancer at the same time being immunosuppressed.
Topics: Anthracosilicosis; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis; Antirheumatic Agents; Arthritis; Chondrocalcinosis; Humans; Immunologic Factors; Lung; Male; Methotrexate; Middle Aged; Multiple Pulmonary Nodules; Rituximab; Thoracoscopy; Tomography, X-Ray Computed
PubMed: 27478398
DOI: 10.1155/2016/9254374