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.

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.

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.

Paciente con nódulos pulmonares sugerentes de metástasis. Silicosis, presentación tardía / Patient with bilateral lung nodes like metastasis. Late silicosis

Presentamos a un paciente de 72 años que ingresa para estudio de nódulos pulmonares múltiples y bilaterales en radiografía de tórax realizada de forma casual. Se realiza biopsia de nódulo pulmonar con el resultado anatomopatológico de silicoantracosis (AU)

We present a 72-year-old patient that he has admitted to analize a large amount and bilateral lung nodes in a incidentally thorax x-ray. It is carried out a lung node biopsy, with a result of silicoanthacosis (AU)

[A clinicopathological study of 16 autopsy cases of anthracosilicosis with lung cancer].

OBJECTIVE: To investigate the clinicopathological characteristics of anthracosilicosis complicated with lung cancer. METHODS: Tissue specimens from 16 autopsy cases of 0(+) anthracosilicosis complicated with lung cancer were retrospectively studied by hematoxylin-eosin, histochemical, and immunohistochemical staining. RESULTS: 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. CONCLUSIONS: 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.

The implication of background anthracosis in the development and progression of pulmonary adenocarcinoma.

In order to characterize the relationship between background anthracosis and pulmonary adenocarcinogenesis, surgically resected tissues of 66 cases of stage I pulmonary adenocarcinoma, 4 cm or less at their greatest dimension, were examined. These cases were diagnosed based on the classification of small-sized adenocarcinoma of the lung (Noguchi et al., Cancer 75, 1995). Thirteen cases were diagnosed as types A (localized bronchioloalveolar adenocarcinoma, LBAC) and B (LBAC with alveolar collapse), 40 cases as type C (LBAC with a focus of fibroblastic proliferation), 8 as type D (poorly differentiated adenocarcinoma) and 5 as types E (bronchial gland type adenocarcinoma) and F (true papillary adenocarcinoma). The 5-year survival rate of types A and B cases was 100%, while those of type C, type D and types E and F were 52%, 48% and 39%, respectively. Nuclear accumulation of abnormal p53 protein in non-replacement type adenocarcinomas (types D, E and F) was detected more frequently than that in replacement type adenocarcinomas (types A, B and C) (P < 0.05). In each case, black dusty material was extracted from tumorous lesions and non-tumorous regions and blotted onto a nitrocellulose membrane. The anthracotic index (AI) was calculated with a densitometer. AIs of non-tumorous regions in early and replacement type adenocarcinomas (types A and B) were significantly less than in relatively advanced (type C) and poorly differentiated (type D) adenocarcinomas (P < 0.05). These results indicated that adenocarcinoma developing in heavily anthracotic lungs readily progresses to an advanced stage, or that adenocarcinoma with a less favorable prognosis tends to develop in severely anthracotic lungs.

Hepatosplenic antracosilicosis: a rare cause of splenic calcifications.

A case of a 62-year-old man with known longstanding pulmonary antracosilicosis, with associated hepatosplenic antracosilicosis, is presented. A CT scan of the upper abdomen revealed multiple calcifications within the spleen, and to a lesser degree within the subcapsular region of the liver, as well as "egg-shell" calcifications of abdominal lymph nodes, most noticeable at the splenic hilum. Although histopathologically not proven, the similar appearance of the calcified hepatosplenic nodules to the small round calcifications scattered throughout the lungs, as well as the typical "egg-shell" morphology of the calcified abdominal lymph nodes, should raise the suspicion of hepatosplenic antracosilicosis.

Localised obliterative bronchitis due to non-occupational mineral dust inhalation.

We present a 56-year-old woman with an infiltrate in the right middle lobe secondary to obstruction of the right middle lobe bronchus by extensive submucosal fibrosis. This unique stenotic lesion of a central bronchus was caused by a domestically acquired localised central obstructive bronchitis due to the inhalation of mixed dust fibers, in the absence of advanced silicosis. This complication is a rare presentation of the myriad of pulmonary diseases associated with mineral dust inhalation.

[The role of pulmonary surfactant in the atherogenesis process in patients with dust-induced respiratory organ diseases]. / Rol' surfaktanta legkikh v protsesse aterogeneza u bol'nykh pylevymi zabolevaniiami organov dykhaniia.

There have been established opposite reactions in the cardiovascular system during formation of dust-induced pathology of lungs: a common finding in patients with pneumoconiosis is alterations in the left heart, while in chronic dust bronchitis the same is true of the right heart. In the authors' opinion, different states of pulmonary surfactant in the above conditions account for this observation. Inhibition of synthesis of the pulmonary surfactant associated with the development of the blood and tissue phospholipid deficiency makes for the evolution of atherosclerosis in patients with pneumoconiosis while enhancement of the phospholipid production by the lungs accompanied by elevation of their blood content is an important factor inhibiting the processes of atherogenesis in patients with dust bronchitis.

[Silicosis and primary Gougerot-Sjögren syndrome]. / Silicose et syndrome de Gougerot-Sjögren primitif.

We report three cases of primary Sjögren's syndrome in silicotic coal miners. All patients fulfilled the diagnostic criteria for Sjögren's syndrome recently established by the European Community study group. One patient had cryoglobulinemia and polynevritis. Another had Raynaud's phenomenon, arthralgia, purpura and polynevritis. Capillary microscopy was normal in all the three patients. Antinuclear antibodies were detected only in one patient, who had also anti-SSa and anti-SSb antibodies. The prevalence of systemic sclerosis, rheumatoid arthritis and probably systemic lupus erythematosus is significantly higher after longstanding occupational exposure to silica. On the contrary, any case of Sjögren's syndrome was till now described in the course of pulmonary silicosis. The physiopathological mechanisms of these associations are misunderstood.

[Pathological observations on massive fibrosis of coal-mine pneumoconiosis].

Morphological studies on massive pulmonary fibrosis due to pneumoconiosis in 42 cases were performed. The cases were divided into two types: the coalescence of fibrotic nodules type and the progressive massive fibrosis type. The former includes fusion of simple silica or coal-silica nodules and coalescence of mainly coal-silico-tubercle nodules. When pneumoconiosis is complicated by tuberculosis, the coal-silico-tubercle is the pathological change caused by the combination of dust and inflammation. The resulting conglomerate mass can be classified as progressive massive fibrosis. A comparison of micro-element content between non-massive fibrosis and massive fibrosis was made, and only the silicon content showed a significant difference (P < 0.05). The morphology, pathogenesis and formation of progressive massive fibrosis are discussed.

[Pathological study of 16 cases of lung cancer with long-term exposure to dusts in coal mine].

16 cases of lung cancer with long-term exposed to dusts in coal mine were studied by autopsies. This group of lung cancer's pathologic characteristics were: The mean of the age of death of the patients were 51.3 yrs, 10 years younger than that of the general population. In addition to the main tumor, multiple origin of bronchial mucosa with epithelial hyperplasia, metaplasia, and carcinoma in situ were seen. Dusts smear were seen under polar-microscope and identification by EDAX in H-800 electronic microscope. According to EDAX analysis, on the surface of some particles, Co, Cr, ions were detected.

[Rapidly progressive glomerulonephritis in pneumoconiotic coal miners]. / Glomérulonéphrites rapidement progressives chez les mineurs de charbon pneumoconiotiques.

We review a series of 11 silicotic coal miners demonstrating a progressive renal failure with a syndrome of rapidly progressive glomerulonephritis. Renal biopsies reveal crescentic glomerulonephritides associated three times with angeitis. These cases confirm that silica induced glomerulonephritides can be an occupational hazard and warrant further clinical and epidemiological research.