ABSTRACT
Anthracosis is black pigment discoloration of bronchi which can cause bronchial destruction and deformity [anthracofibrosis]. A prospective, case-control study was performed to evaluate potential underlying causes of anthracosis on 190 subjects who referred for various indications. Age of patients ranged from 10-85 yrs. 46% of male patients were farmers and 27% were manual workers, whereas 91% of female patients were housewives. During bronchoscopy, special attention was given to anthracotic plaque, bronchial deformity, infiltration, or vegetation. Broncho-alveolar lavage was performed for further cytopathological, acid-fast bacilli staining [AFB] and culture in all cases. No correlation between occupational exposure to dust and two kinds of anthracosis [anthracotic plaque and antracofibrosis] was present. In anthracofibrotic patients, 81% were nonsmokers. The principal finding in bronchoscopy was simple plaque of anthracosis in 21% and anthracofibrosis in 12%. Sputum smear showed macrophages containing anthracotic granules in 71%. Patients with anthracosis had positive histopathology for tuberculosis [21%] that was not significantly different from subjects without anthracosis. Of 40 patients with simple anthracotic plaque and 22 with anthracofibrosis, only two and one patients, respectively were proven to have bronchogenic carcinoma that was not statistically more common than in the control group. Other etiology for anthracofibrosis should be investigated
Subject(s)
Humans , Male , Female , Anthracosilicosis , Lung Neoplasms , Smoking , Occupational Diseases , Prospective Studies , Case-Control StudiesABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinicopathological characteristics of anthracosilicosis complicated with lung cancer.</p><p><b>METHODS</b>Tissue specimens from 16 autopsy cases of 0(+) anthracosilicosis complicated with lung cancer were retrospectively studied by hematoxylin-eosin, histochemical, and immunohistochemical staining.</p><p><b>RESULTS</b>All of 16 patients were male. The patient's age ranged from 46 to 57 years (average: 52.8 years). The dust-exposure time were over 25 years. The pneumoconiosis and dust fibrosis of different degrees in the lung were found. The positive detected rate of coal silicotic nodules was 93.75% (15/16). Among 16 cases of lung cancer, there were 5 cases of squamous cell carcinoma, and 5 cases of small cell undifferentiated carcinoma, 3 cases of bronchioloalveolar carcinoma, 2 cases of adenocarcinoma and 1 case of adenosquamous carcinoma. The typical pathological changes of anthracosilicosis complicated with lung cancer were: the cancer tissue was located at the side of coal dust fibrous focus and fibrosis lesion, or mixte with silicotic lesion. CK, EMA and CEA were positively expressed in most of the tumor cells, while vimentin was positive in the fibrocyte of dust fibrosis.</p><p><b>CONCLUSIONS</b>The occurrence of some lung cancer may be related with fibrosis. The dust-exposed workers can suffer from lung cancer which is histologically identical to the general lung tumor. PCNA and Ki67 may be a prognostic index for anthracosilicosis with lung cancer, while vimentin may be a marker for the examination of dust fibrosis in anthracosilicosis.</p>