Hallazgos microscópicos del tejido pulmonar y los músculos respiratorios en la Enfermedad Pulmonar Obstructiva Crónica (EPOC) / Microscopic Findings Of Lung Tissue And Respiratory Muscles In Chronic Obstructive Pulmonary Disease (COPD)

Introducción: En la enfermedad pulmonar obstructiva crónica (EPOC), el diafragma y los músculos respiratorios esternocleidomastoideos (ECOM) funcionan contra el aumento de las cargas mecánicas debido a la limitación del flujo de aire y los cambios en la conformación del tórax debido a la condición de hiperinflación pulmonar. Objetivo: Evaluar los cambios histopatológicos presentes en los pulmones y los músculos respiratorios (diafragma y ECOM) de los cadáveres con Diagnostico de EPOC. El Estudio: Este es un estudio ciego y descriptivo con análisis de imágenes histológicas de biopsia. El historial de tabaquismo asociado con la presencia de antracosis pulmonar, engrosamiento septal y bullas enfisematosas comprendió los criterios de inclusión del estudio. La muestra consistió en biopsias de pulmón, diafragma y ECOM. El estudio se realizó mediante análisis microscópico óptico de lâminas histológicas obtenidas de 36 cadáveres con EPOC. El diagnóstico histopatológico fue realizado por un patólogo que desconocía los objetivos del estudio. Hallazgos: En el diafragma, hubo la presencia de tejido adiposo interpuesto, atrofia muscular, eliminación de las fibras musculares y fibrosis. En el ECOM, también se evidenció la eliminación de las fibras musculares, la atrofia muscular, el tejido adiposo interpuesto, la hipertrofia muscular y el engrosamiento de los tendones. Conclusiones: Los cambios encontrados en las biopsias musculares de diafragma y ECOM de los cadáveres con EPOC se evidenciaron como un mecanismo de compensación y/o disfunción del sistema respiratorio debido a alteraciones biomecánicas promovidas por la enfermedad.

Introduction: In chronic obstructive pulmonary disease (COPD), the diaphragm and sternocleidomastoid respiratory muscles (ECOM) work against increased mechanical loads due to limited air flow and changes in chest conformation due to the condition of pulmonary hyperinflation. Objective: To evaluate the histopathological changes present in the lungs and respiratory muscles (diaphragm and ECOM) of the corpses affected by COPD. Materials and methods: This is a blind and descriptive study with analysis of histological images of biopsy. The history of smoking associated with the presence of pulmonary anthracosis, septal thickening and emphysematous bullae included the inclusion criteria of the study. The study was conducted by optical microscopic analysis of histological sheets obtained from 36 corpses with COPD. The histopathological diagnosis was made by a pathologist who did not know the objectives of the study. Results: In the diaphragm, there was the presence of interposed adipose tissue, muscle atrophy, removal of muscle fibers and fibrosis. In ECOM, the elimination of muscle fibers, muscular atrophy, interposed adipose tissue, muscle hypertrophy and thickening of the tendons were also evident. Conclusions: The changes found in the diaphragm and ECOM muscle biopsies of the bodies with COPD were evidenced as a mechanism of compensation and / or dysfunction of the respiratory system due to biomechanical alterations promoted by the disease.

A fire death with a rare finding: anthracosis or soot embolism?

Charred human remains were found in the smoking ambers of a dying fire in an oil palm plantation in Selangor, Malaysia in the midnight of January 28, 2013. Investigations showed that palm fronds and rubber tires were used to light and sustain the blaze. At least four to five tires were estimated to be used based on the residual burnt metal wires at the site. The remains were brought to the Department of Forensic Medicine, Hospital Sungai Buloh, Selangor for post-mortem examination. Pre-autopsy imaging showed a fractured skull with presence of a bullet in the head. The body belonged to a male with unrecognizable facial features, pugilistic attitude, and reduced body size caused by fire damage with sparing of the posterior surface. A large fracture was present at the skull vault. An entry gunshot wound was observed on the left side of the body of mandible, which was associated with base of skull fracture. Heat-related fractures were also noted on the right side of the frontal bone. A projectile was retrieved from the right side of the occipital lobe. Further examination showed presence of soot and hyperaemic larynx, trachea, main bronchi, and oesophagus. Black spots measuring 1 to 2 mm were present on the surface and parenchyma of the heart, liver, pancreas and kidneys. Histopathology examination showed black particles within the vessels in the affected organs. We report this rare finding in a charred body and present a discussion based on published literature on this issue.

Clinical Relevance of Bronchial Anthracofibrosis in Patients with Chronic Obstructive Pulmonary Disease Exacerbation / 결핵및호흡기질환

BACKGROUND: Bronchial anthracofibrosis (BAF), which is associated with exposure to biomass smoke in inefficiently ventilated indoor areas, can take the form of obstructive lung disease. Patients with BAF can mimic or present with an exacerbation of chronic obstructive pulmonary disease (COPD). The purpose of the current study was to investigate the prevalence of BAF in Korean patients with COPD exacerbation as well as to examine the clinical features of these patients in order to determine its clinical relevance. METHODS: A total of 206 patients with COPD exacerbation were divided into BAF and non-BAF groups, according to computed tomography findings. We compared both clinical and radiologic variables between the two groups. RESULTS: Patients with BAF (51 [25%]) were older, with a preponderance of nonsmoking women; moreover, they showed a more frequent association with exposure to wood smoke compared to those without BAF. However, no differences in the severity of illness and clinical course between the two groups were observed. Patients in the BAF group had less severe airflow obstruction, but more common and severe pulmonary hypertension signs than those in the non-BAF group. CONCLUSION: Compared with non-BAF COPD, BAF may be associated with milder airflow limitation and more frequent signs of pulmonary hypertension with a more severe grade in patients presenting with COPD exacerbation.

Paranasal Sinusitis Occurred by Anthracosis / 대한이비인후과학회지

Anthracosis is a black pigmentation of bronchial mucosa or lung parenchyma induced by inhaled soot. It is most commonly found in those persons who have worked as coal miners. Anthracosis is known to be induced when coal dust remains on the surface of the mucous membranes after it is inhaled through the bronchi, which can cause changes or atrophy of the upper airway and abnormality of the self-purification function and it can disrupt the defensive reaction of the respiratory organs. To our knowledge, there has been no report of recurrent paranasal sinusitis caused by anthracosis. Herein, with a review of the literature, we report a rare case of paranasal sinusitis caused by anthracosis in a 51-year-old man.

Serum Levels of Interleukin-8 and Tumor Necrosis Factor-alpha in Coal Workers' Pneumoconiosis: One-year Follow-up Study

OBJECTIVES: Various cytokines induced by inhalation of coal dust may mediate inflammation and lead to tissue damage or fibrosis, such as coal workers' pneumoconiosis (CWP). METHODS: To investigate the relevance of serum cytokines in CWP, the levels of serum interleukin-8 (IL-8) and tumor necrosis factor-alpha (TNF-alpha) as CWP biomarkers in 110 retired coal miners (22 controls and 88 CWP subjects) were related to cross sectional findings and 1-year progressive changes of the pneumoconiosis. Progressive changes of CWP were evaluated by paired comparison of chest radiographs. Analysis by a receiver operating characteristic curve assessed the biomarker potential of each cytokine. RESULTS: The mean serum IL-8 level was significantly higher in CWP compared to controls and IL-8 levels correlated with the degree of CWP. The median serum TNF-alpha level was significantly higher in subjects with progressive CWP compared to subjects without CWP progression. The area under the ROC curve for IL-8 (0.70) and TNF-alpha (0.72) for CWP identification and progression, respectively, indicated the biomarker potential of the two cytokines. Serum cutoff values of IL-8 and TNF-alpha were 11.63 pg/mL (sensitivity, 69%; specificity, 64%) and 4.52 pg/mL (sensitivity, 67%; specificity, 79%), respectively. CONCLUSION: The results suggest that high levels of serum IL-8 are associated with the presence of CWP and those of serum TNF-alpha are associated with the progression of CWP.

General anesthesia in a patient with known bronchial anthracofibrosis: A case report / 대한마취과학회지

Bronchial anthracosis was recently defined in the English radiology literature as a luminal narrowing associated with anthracotic pigmentation on bronchoscopy without a relevant history of pneumoconiosis or smoking. Anthracosis refers to the presence of carbon particles in the lungs, not to a disorder per se. Anthracofibrotic lesions carry the potential risk of massive hemorrhage during endobronchial procedures. This report describes a case of general anesthesia for a left modified radical mastectomy due to an intraductal carcinoma in a patient with known bronchial anthracofibrosis.

Mediastinum Anthracosis Resembling Metastatic Carcinoma from Thyroid Gland

The differential diagnosis of mediastinal lymph node enlargement is mandatory, since the diagnosis of mediastinal lymph node enlargement covers a broad spectrum of diseases including inflammatory reactions, infections, and cancer metastases. We describe here a 51-year-old woman with anthracosis in mediastinal lymph node, mimicking metastatic carcinoma from the thyroid gland.

Charcoal-induced anthracosis of the terminal ileum / 대한내과학회지

Anthracosis is a very common disease of the bronchus, while anthracosis of the gastrointestinal tract is extremely rare. Only a few cases of anthracosis of the esophagus have been reported and no cases of anthracosis of the terminal ileum are known, except one patient in Korea who was described as having melanosis ilei. A black pigmented lesion was detected in the terminal ileum on colonoscopic examination of a 51-year-old woman. Histological examination revealed a pigmented lesion beneath the mucosal epithelial layer and lymphoid follicular hyperplasia. The lesion consisted of an aggregation of histiocytes containing abundant tiny black pigments. She has taken oral charcoal for 7 years. We diagnosed anthracosis of the terminal ileum caused by oral charcoal and report a case of charcoal-induced anthracosis of the terminal ileum.

A Case of Esophageal Anthracosis with Polypoid Features / 대한소화기내시경학회지

Anthracosis mostly occurs at the lung and esophageal anthracosis has rarely been reported. As a result, the pathogenesis and prognosis of esophageal anthracosis is currently unclear. In previous reports, esophageal anthracosis has been mostly observed as relatively flat lesions that require differentiation from malignant melanoma. We report here on a case of esophageal anthracosis with polypoid features in a seventy year old male patient with hepatocellular carcinoma. The patient had undergone endoscopic examination and a 1 cm sized black polypoid lesion was observed. Pathology revealed macrophages phagocyting black carbon pigments beneath the mucosal epithelium and the diagnosis of esophageal anthracosis was made.

Features of anthracosis at the department of occupation al diseases at Thanh nhan hospital

In Janruary – November 2001 period, at Thanh Nhan Hospital (Hanoi), 50 patients with pneumoconiosis were studied. Pneumoconiosis is common and accounts for 7.47% of all occupational diseases. The most common ones are acquired by silice, cotton dust and feather dust. The severity is related mainly with the exposure duration, the history of frequently acquired respiratory diseases. Common symptoms are dypnoea 70%, cough 62%, sputum 40%, diverse rale of lung 52%, changes of lung X-ray image, electrocardiogramme and especially impairing lung function. The common conditions and complications are pneumonia, heart failure, chronique heart – lung syndrome, heart dysrhytmia, hemophtisia and pulmonary infarction

Hepatic Anthracosis: A case report

The authors report a case of hepatic anthracosis, which was found incidentally during cholecystectomy in a 73 year-old woman with acute cholecystitis. Hepatic anthracosis is a very rare condition among pigmentary lesions of the liver. Light microscopic examination revealed black granular pigments within Kupffer cells, particularly adjacent to the terminal hepatic venules, and macrophages at the portal tracts. The pigments did not show birefringence under the polarizing microscope and did fade out following pretreatment with alcoholic picric acid, confirming themselves anthracotic pigments.