Microscopic feature of lymph node anthracosilicosis adherent with pulmonary artery: a case report.

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.

Associations of polymorphisms in the cytokine genes IL1ß (rs16944), IL6 (rs1800795), IL12b (rs3212227) and growth factor VEGFA (rs2010963) with anthracosilicosis in coal miners in Russia and related genotoxic effects.

Anthracosilicosis (AS), a prevalent form of pneumoconiosis among coal miners, results from the accumulation of carbon and silica in the lungs from inhaled coal dust. This study investigated genotoxic effects and certain cytokine genes polymorphic variants in Russian coal miners with АS. Peripheral leukocytes were sampled from 129 patients with AS confirmed by X-ray and tissue biopsy and from 164 asymptomatic coal miners. Four single-nucleotide polymorphisms were genotyped in the extracted DNA samples: IL1ß T-511C (rs16944), IL6 C-174G (rs1800795), IL12b A1188C (rs3212227) and VEGFA C634G (rs2010963). Genotoxic effects were assessed by the analysis of chromosome aberrations in cultured peripheral lymphocytes. The mean frequency of chromatid-type aberrations and chromosome-type aberrations, namely, chromatid-type breaks and dicentric chromosomes, was found to be higher in AS patients [3.70 (95% confidence interval {CI}, 3.29-4.10) and 0.28 (95% CI, 0.17-0.38)] compared to the control group [2.41 (95% CI, 2.00-2.82) and 0.09 (95% CI, 0.03-0.15)], respectively. IL1ß gene T/T genotype (rs16944) was associated with AS [17.83% in AS patients against 4.35% in healthy donors, odds ratio = 4.77 (1.88-12.15), P < 0.01]. A significant increase in the level of certain chromosome interchanges among AS donors is of interest because such effects are typical for radiation damage and caused by acute oxidative stress. IL1ß T allele probably may be considered as an AS susceptibility factor among coal miners.

68Ga-PSMA-Ligand PET/CT Uptake in Anthracosilicosis.

This interesting image illustrates a case of biopsy-proven pulmonary anthracosilicosis, a mixed dust pneumoconiosis, associated with Ga-PSMA-ligand uptake. Prostate-specific membrane antigen (PSMA) is an emerging imaging biomarker, with clinical application in evaluation of prostate cancer using Ga-PSMA-ligand PET/CT. Contrary to its name, PSMA is expressed in a number of other normal tissues and pathological states. Prostate-specific membrane antigen expression has been linked to tumor angiogenesis in various other epithelial neoplasms, as well as neovasculature associated with tissue regeneration and repair. Awareness of nonneoplastic inflammatory conditions associated with Ga-PSMA-ligand uptake aids in patient assessment and management.

Rapid Growth of Lung Nodules due to Combined Pulmonary Vasculitis, Silicoanthracosis, and Chondrocalcinosis.

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.

Specificity of morphologic changes in target organs, associated with exposure to coal rock dust and fluorine compounds.

The studies revealed specificity of morphologic changes in target organs, depending on acting occupational hazard. Evidences are that inhalation of coal rock dust causes irreversible sclerotic and degenerative changes mostly in lungs and bronchi even on 6th week of the experiment. In liver, changes in parenchyma and stroma are controlled by reparative processes by 9th week. Accumulation of sodium fluoride in the body causes irreversible necrotic changes mostly in liver, on 6th week of the intoxication. With that, morphologic changes in lungs and bronchi are minor, characterized by immune inflammation with degenerative changes only after the 9th week. Irrespective of the acting hazard, vascular changes are characterized by media and intima hypertrophy with endothelial dystrophy and hyalinosis since the 6th week of the experiment.

Diagnostic features of atherosclerosis development in miners having anthracosilicosis.

To design forecasting system, the authors studied occurrence of atherosclerosis and its risk factors in 152 workers of coal mines in South Kouzbass (tunnellers, cleaning pit-face miners, mining excavator operators), suffering from anthracosilicosis. Atherosclerosis was revealed in 124 (81.6%) workers with anthracosilicosis. With Bayess method for independent signs and Wald's sequential analysis method, the authors created a way to forecast atherosclerosis with coronary, extracranial and peripheral arteries involvement in miners with anthracosilicosis. Maximal risk of atherosclerosis in miners with anthracosilicosis is associated with following parameters: age 45 years and over, arterial hypertension, smoking, abdominal obesity type, diabetes mellitus, metabolic syndrome, respiratory failure, family history of IHD, hypercholesterolemia, increased LDL cholesterol, decreased HDL cholesterol, increased atherogeneity coefficient, hypertriglyceridemia, hyperhomocysteinemia, hyperfibrinogenemia, increased C-reactive protein, hypersthenic type according to Reese-Isenc index, andromorphic type according to Tanner index, blood group. markers A (II) and B (III), rhesus negative, MN and NN. Through increased number of factors analyzed and selected additional markers, accuracy of atherosclerosis forecasting is increased - that enables to proceed with opportune treatment and prevention.

Experimental Study of the Mechanisms of Intracellular Defense in Cardiomyocytes Associated with Stages of Anthracosilicosis Development.

Mechanisms of intracellular defense of rat cardiomyocytes were studied in dynamics of anthracosilicosis development induced by long-term inhalation of coal and rock dust. It was shown that synthesis of transcription factor HIF-1α and protective proteins increased in the heart at the early stages of coal and rock dust inhalation (1-3 weeks), and these changes limited the development of free radical oxidation and activated metabolism of glucose and fatty acids. Exposure to coal and rock dust for 6-12 weeks activated free radical oxidation and decreased basal metabolism in cardiomyocytes.

Diagnóstico por la imagen de la antracofibrosis bronquial aislada: un análisis de tomografía computarizada de pacientes con confirmación broncoscópica e histológica / Imaging Findings of Isolated Bronchial Anthracofibrosis: A Computed Tomography Analysis of Patients With Bronchoscopic and Histologic Confirmation

Antecedentes: Evaluar los resultados de la tomografía computarizada (TC) de tórax en pacientes con antracofibrosis bronquial aislada demostrada broncoscópica y anatomopatológicamente. Metodología: Se incluyó en el estudio a un total de 58 pacientes con antracofibrosis bronquial aislada (29 mujeres; media de edad, 70 años). El diagnóstico de antracofibrosis bronquial se estableció en función de las observaciones broncoscópicas y anatomopatológicas en todos los pacientes. Los diversos aspectos observados en la TC torácica fueron revisados retrospectivamente por 2 radiólogos torácicos, que tomaron las decisiones por consenso. Resultados; Resaltamos el engrosamiento del tejido blando peribronquial central (n = 37, 63,8%) como un hallazgo importante en las exploraciones de imagen, que causa estenosis (n = 37, 63,8%) u obstrucción bronquial (n = 11, 19%). Se observaron múltiples estenosis bronquiales con afectación simultánea de 2, 3 y 5 bronquios en 12 (21%), 9 (15%) y 2 (3,4%) pacientes, respectivamente. Se detectaron atelectasias segmentarias y colapsos lobulares y multilobulares. Estas observaciones se realizaron sobre todo en el pulmón derecho, con un predominio del lóbulo medio derecho. Se observaron también patrones de atenuación en mosaico, nódulos parenquimatosos diseminados, patrones nodulares y ganglios linfáticos calcificados o no calcificados. Conclusiones: En la TC de tórax, la antracofibrosis bronquial aislada se observa en forma de engrosamiento de tejido blando peribronquial, estenosis u obstrucción bronquiales, atelectasia segmentaria o colapso lobular o multilobular. Estas observaciones fueron más frecuentes en el lado derecho, con múltiples bronquios afectados de manera simultánea en algunos pacientes

Background: To evaluate the chest computed tomography (CT) findings of patients with isolated bronchial anthracofibrosis confirmed by bronchoscopy and histopathology. Methodology: Fifty-eight patients with isolated bronchial anthracofibrosis (29 females; mean age, 70 years) were enrolled in this study. The diagnosis of bronchial anthracofibrosis was made based on both bronchoscopy and pathology findings in all patients. The various chest CT images were retrospectively reviewed by two chest radiologists who reached decisions in consensus. Results: Central peribronchial soft tissue thickening (n = 37, 63.8%) causing bronchial narrowing (n = 37, 63.8%) or obstruction (n = 11, 19%) was identified as an important finding on imaging. Multiple bronchial stenoses with concurrentinvolvement of 2, 3, and 5 bronchi were seen in 12 (21%), 9 (15%), and 2 (3.4%) patients, respectively. Segmental atelectasis and lobar or multilobar collapse were detected. These findings mostly occurred in the right lung, predominantly in the right middle lobe. Mosaic attenuation patterns, scattered parenchymal nodules, nodular patterns, and calcified or non-calcified lymph nodes were also observed. Conclusions: On chest CT, isolated bronchial anthracofibrosis appeared as peribronchial soft tissue thickening, bronchial narrowing or obstruction, segmental atelectasis, and lobar or multilobar collapse. The findings were more common in the right side, with simultaneous involvement of multiple bronchi in some patients

Debilitating lung disease among surface coal miners with no underground mining tenure.

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.

[Contemporary features of pneumoconiosis formation and course in miners of East Donbass].

The author analyzed dynamics and structure of occupational morbidity including pneumoconiosis in Rostov region of Russian Federation, since 1990 until now. They were compared with analogous parameters of previous historical period. Findings are that contemporary dynamics of anthracosilicosis clinical features is characterized by severily reduced terms of the disease development from medical registration of the diseased miner, earlier addition of malignancy, respiratory failure and other complications--that in aggregate causes earlier disablement and drastically reduced survival rate in occupational patients with anthracosilicosis.

Calcareous concretions and psammoma bodies in sputum smears: do these similar structures have different clinical significance?

Different noncellular elements, such as round concentric calcified laminated structures, may be found in sputum smears. If these structures appear isolated on the background of the smear, the term usually used to describe them is "calcareous concretions" (CC). On the contrary, when the structures are part of epithelial cell groups or small tissue fragments, the term used to describe them is "Psammoma bodies" (PB). The aim of this work is to establish the relationship between these structures and pulmonary disease, especially lung carcinoma, by searching for the presence of CC and/or PB in sputum smears. Our study has taken as a basis 16.716 sputum smears from 696 patients obtained during a 7-year period (2003-2009). After reviewing them, it was found that from the total, 66 cases (0.39%) contained round calcified structures, 57 of them (0.34%) corresponding to CC, and the remaining 9 ones (0.05%) corresponding to PB. From these 57 CC cases, 56 corresponded to benign entities, and only one was found with lung carcinoma. On the other hand, from the 9 PB cases all of them (100%) were related to lung adenocarcinoma. We conclude that, even having a similar morphological structure, these aforementioned calcified structures we have observed in sputum smears have different and relevant clinical significance.

Amiloidosis nodular pulmonar / Nodular pulmonary amyloidosis

No disponible

[Specificity of cellular response to various occupational toxicants].

The article covers study concerning influence of coal rock dust and high fluorine concentrations on energy metabolism and oxidation-reduction reactions in blood WBC of experimental rats. The authors demonstrated that the cells vary in response to long action of coal rock dust and high fluorine concentrations.

[Clinical and experimental studies of metabolic response to chronic exposure to coal dust].

In miners anthracosilicosis is caused by chronic exposure to coal dust and is characterized by progressive development of the inflammatory process, the expressed disorders of lipid metabolism, and immunodeficiency. In the experiment we revealed the stages of anthracosilicosis development according to which adequate measures of prevention and correction of the disorders caused by long exposure of an organism to coal dust are recommended.

[Quantitative characteristics of pathomorphologic changes in bronchi and pulmonary artery branches in miners with preroentgenologic stage of anthrasilicosis].

Morphometric studies covered lung tissue of 10 miners exposed to dusty work conditions over 1 to 30 (13.4 +/- 3.6) years, who were considered apparently healthy according to follow-up examinations and died in technogenic accident. Findings are that dysregeneration, hypertrophic and sclerotic changes in respiratory part of lungs, in bronchi and in pulmonary circuit arteries develop simultaneously--that proves common pathogenetic concept of these changes and systemic character of the pneumoconiosis. The results necessitate improved methods to evaluate health state of workers, refined criteria for nosologic diagnosis of respiratory diseases related to dust.

Silicoantracosis: una forma de presentación clinicorradiológica excepcional simulando metástasis pulmonares / Anthracosilicosis: a rare clinical and radiological presentation simulating lung metastases

El caso que presentamos es el de un paciente asintomático con un diagnóstico clínico rradiológico inicial de metástasis pulmonares. Una vez efectuado el estudio anatomopatológico de las lesiones pulmonares, se realiza el diagnóstico final de silicoantracosis. Tras una exhaustiva revisión bibliográfica, se ha comprobado que el caso de silicoantracosis que se presenta tiene una forma de presentación excepcional, tanto en las manifestaciones radiológicas como en el largo período de latencia (unos 50 años) entre una breve exposición al polvo del carbón (de 6 años) y la expresión radiológica (AU)

We present the case of an asymptomatic patient with an initial clinical and radiological diagnosis of lung metastases in whom histological study diagnosed anthracosilicosis. A review of the literature shows that this presentation of anthracosilicosis is exceptional; our patient had atypical radiological findings and a very long latency period (over 50 years) after a brief (nearly 6 years) exposure to coal dust (AU)