1/11. Esophageal anthracosis: lesion mimicking malignant melanoma.A case of anthracosis of the esophagus is reported. The patient was a previously healthy 69-year-old Japanese woman. A black and slightly elevated lesion was detected in her esophagus by upper gastroesophageal fiberoscopic examination. Endoscopically, the lesion looked like malignant melanoma. Thoracic esophagotomy was then performed. Histological examination revealed a pigmented lesion beneath the mucosal epithelial layer. The lesion consisted of an aggregation of histiocytes containing an abundance of tiny black pigments. A few mature lymphocytes and plasma cells were also evident in the periphery of the lesion. Histologically, these findings looked like lymph nodes in the pulmonary hilus; however, no lymph nodal structure was evident in the esophageal wall. traction diverticula were also noted in the pigmented lesion. The patient has remained well without disease for 9 months since the surgery. Although anthracosis is a rare condition in the esophagus, the present case gave warning to pathologists and clinicians that it does indeed occur. Endoscopists and pathologists should differentiate anthracosis from malignant melanoma because the treatment and outcome are quite different for each.- - - - - - - - - - ranking = 1keywords = black (Clic here for more details about this article) |
2/11. Detection of graphite using laser microprobe mass analysis of a transbronchial biopsy from a foundry worker with mixed dust pneumoconiosis.inhalation of dust containing graphite can cause lung disease in foundry workers and workers in graphite mines or mills. Mixed dust pneumoconiosis caused by long-term occupational exposure to graphite dust is a rare disease. Only a few cases of graphite pneumoconiosis have been reported in literature, and these were usually diagnosed post mortem. Our report is of an 80-year-old male patient who had worked in an iron foundry for 20 years and whose work had entailed regular contact with ground graphite and foundry vapors. Chest x-rays revealed both a reticular and nodular pattern in the lung, moderate apical distractions and pleural scarring, all of which were confirmed by high-resolution computed tomography. bronchoalveolar lavage and transbronchial biopsies were also consistent with mixed dust pneumoconiosis, and due to the long-term dust exposure, graphite pneumoconiosis was strongly suspected. To confirm this diagnosis, the chemical composition of the dark granules in the semi-thin histological sections of the transbronchial biopsies were analyzed using laser microprobe mass spectroscopy. The mass spectra of these black particles were consistent with those of natural graphite powder. Comparative analyses of normal lung tissue did not produce similar spectral patterns. We conclude that histology and cytology does not always suffice to confirm a diagnosis of graphite pneumoconiosis, because black particles are also found in conditions resulting from other exposures, such as heavy smoking or coal mining. Analysis of the composition of particles deposited in the lung tissue offers more precise information, which can be used as evidence in occupational and forensic medicine. Laser microprobe mass spectroscopy can assess the mineral dust load in lung samples.- - - - - - - - - - ranking = 1keywords = black (Clic here for more details about this article) |
3/11. titanium particles identified by energy-dispersive X-ray microanalysis within the lungs of a painter at autopsy.A 72-year-old male painter, who complained of his "lungs burning" for 2 weeks, died suddenly. autopsy examination revealed severe coronary atherosclerosis with plaque rupture as the cause of death. Examination of the lungs revealed emphysema, interstitial fibrosis, and multinucleated giant cells with intra- and extracellular brown-black, crystalline, polarizable foreign material. Energy-dispersive X-ray microanalysis showed the material to contain titanium, aluminum, silicon, and iron. An increased incidence of respiratory disease has been reported in professional painters. titanium is widely used as a pigment in the manufacturing of commercial paints. Cases of pneumoconiosis and alveolar proteinosis have been described in painters in which analysis of lung tissue revealed increased levels of titanium. This case is presented as an example of a rarely reported phenomenon, which may have clinical implications for evaluation and management of lung disease in painters.- - - - - - - - - - ranking = 0.5keywords = black (Clic here for more details about this article) |
4/11. lung disease 35 years after aspiration of activated charcoal in combination with pulmonary lymphangioleiomyomatosis. A histological and clinicopathological study with scanning electron microscopic evaluation and element analysis.Activated charcoal provides effective treatment for most toxic ingestions. Accidental aspiration of activated charcoal is rare. Previously, there have been a few single cases reported on charcoal-related pulmonary complications. We describe an unusual case of pulmonary lesions 35 years after accidental aspiration of activated charcoal. The 38-year-old female patient presented with recurrent pneumothorax. A routinely performed chest roentgenogram revealed pulmonary lesions, highly suggestive to lymphangioleiomyomatosis (LAM). Histopathological investigation of the lung tissue demonstrated some features of LAM but showed prominent pneumoconiotic lesions with cystic tissue destruction. The pneumoconiotic reaction was characterized by prominent black deposits accompanied by foreign-body granuloma formation and minimal fibrosis. Scanning electron microscopic investigation of these deposits showed particles measuring up to 300 microm in greatest diameter. Energy-dispersive X-ray spectra of these particles revealed carbon-rich material, presumably charcoal. The aspiration event was confirmed by the clinical history. To our knowledge, this is the first report not only on a long-term follow-up after aspiration of activated charcoal but also on charcoal-related pulmonary lesions in combination with LAM.- - - - - - - - - - ranking = 0.5keywords = black (Clic here for more details about this article) |
5/11. Massive melanoptysis: a serious unrecognized complication of coal worker's pneumoconiosis.Black sputum is produced when cavitation of progressive massive fibrosis occurs due to mycobacterial and anaerobic bacterial infections (67%) or ischaemic necrosis. The blackish or greyish sputum suggests cavitation of conglomerated masses; the acinar shadows in gravity dependent areas together with cavitary pneumoconiosis, make us suspect an insufficiency of bronchial clearing. bronchoscopy confirms the diagnosis by showing the airway blocked by dark material. During melanoptysis the patient suffers respiratory failure which can be fatal. Close vigilance of the arterial blood gases is essential. Measures must be taken to maintain clear airways. Melanoptysis should be listed with the other complications of coal worker's pneumoconiosis.- - - - - - - - - - ranking = 0.5keywords = black (Clic here for more details about this article) |
6/11. pathology of silicon carbide pneumoconiosis.silicon carbide is a widely used synthetic abrasive manufactured by heating silica and coke in electric furnaces at 2400 degrees C. Until recently it had been considered a relatively inert dust in humans and animals. However, several roentgenologic surveys had revealed lesions similar to low-grade silicosis. A recent epidemiological study has revealed a 35% incidence of pulmonary problems. tissues from three such workers were available for light microscopy. A mixed pneumoconiosis was found, and lesions can be summarized as follows: (a) abundance of intraalveolar macrophages associated with a mixture of inhaled particles including carbon, silicon, pleomorphic crystals, silicon carbide, and ferruginous bodies showing a thin black central core; (b) nodular fibrosis, generally profuse, containing silica and ferruginous bodies and associated with large amount of carbon pigment; (c) interstitial fibrosis, less prominent than the nodular form; (d) carcinoma in two cases. We believe this pneumoconiosis is sufficiently characteristic to be recognized as a distinct entity. The Stanton hypothesis on fiber properties and carcinogenesis could be applied to silicon carbide dust. At present, it appears that the occupational hazard is limited to the manufacturing process and powdered product used in some industries.- - - - - - - - - - ranking = 0.5keywords = black (Clic here for more details about this article) |
7/11. Quantitative x ray microanalysis of pulmonary mineral particles in a patient with pneumoconiosis and two primary lung tumours.The right upper lung lobe of a 74 year old man was resected for a central tumour. Two primary cancers were found; a central small cell carcinoma and a peripheral squamous cell carcinoma. In addition, the peripheral lung tissue showed generalised peribronchiolar fibrosis extending from the non-respiratory bronchioles to the level of the alveolar ducts. Abundant asbestos bodies and large amounts of black dust were seen around the bronchioles. Pulmonary mineral particles were studied by quantitative energy dispersive x ray microanalysis (EDS) using scanning transmission electron microscopy (STEM). The x ray spectra for mineral particles were measured in thin sections, and the characteristic peak intensities of the elements were converted to weight fractions (in oxides). The results enabled the minerals present to be identified and their presence confirmed by calculating the mineral formula. These originated from nine natural minerals, anthophyllite and chrysotile asbestos, talc, and quartz, feldspars, and muscovite, which are components of sand, and also from two artificial mullites used in fire clay. The exposure history of the patient explained the most likely origins of the minerals detected. The patient had been a mason for 23 years, repairing and demolishing stoves and fireplaces and using asbestos for insulation work.- - - - - - - - - - ranking = 0.5keywords = black (Clic here for more details about this article) |
8/11. pneumoconiosis in workers exposed to silicon carbide.Two men who had been exposed only to silicon carbide for many years in a factory manufacturing refractory bricks developed bilateral reticulonodular densities, as shown on chest radiograms, and complained of dyspnea. An open lung biopsy of one of them showed a large amount of black material in the fibrosed alveolar septums. Studies by x-ray diffraction revealed that the silicon carbide to which they were exposed did not contain quartz; X-ray powder diffraction analysis of the lung tissue revealed at least 6 different silicon carbides, traces of tungsten carbide, and an insignificant amount of quartz. Line-width analysis of the pattern suggested that the lung contained foreign material, with a significant number of particles smaller than 0.1 micron. The etiologic role of silicon carbide for tissue fibrosis is discussed.- - - - - - - - - - ranking = 0.5keywords = black (Clic here for more details about this article) |
9/11. Intrapulmonary lymph nodes.We report two cases of intrapulmonary lymph nodes detected by a chest roentgenogram or CT scan. The first patient was a 61-year-old fisherman referred complaining of cough and hemosputum. Chest roentgenogram showed a subpleural small nodular shadow at the superior segment of the right lower lobe. thoracotomy showed a small anthracotic lymph node. The other case was a 68-year-old female patient admitted for further examination of a subpleural small nodular shadow at the latero-basal segment of the left lower lobe detected on a chest CT scan. Thoracoscopic surgery revealed that the black nodule was an anthracotic lymph node. The appearance of an intrapulmonary lymph node on radiological examination is rare, however, it should be considered in the differential diagnosis of a solitary or multiple peripheral pulmonary nodules in adults. A small nodular shadow should be resected if malignancy is suspected though not proven. Subpleural intrapulmonary lymph node warrants thoracoscopic surgery.- - - - - - - - - - ranking = 0.5keywords = black (Clic here for more details about this article) |
10/11. Nonasbestos ferruginous bodies in sputum from a patient with graphite pneumoconiosis: a case report.BACKGROUND: inhalation of graphite dust can cause lung disease, mostly in the form of mixed-dust pneumoconiosis in individuals working in the metallurgic industry or graphite mines. The morphologic landmark of graphite pneumoconiosis is nonasbestos ferruginous bodies with a black graphite core. CASE: In the sputum of an 81-year-old male, characteristic nonasbestos ferruginous bodies were identified. The occupational history confirmed long exposure to natural graphite in metallurgy. CONCLUSION: By the identification of typical ferruginous bodies, the screening of sputum smears may confirm the clinical and radiologic suspicion of pneumoconiosis and may contribute to determining its causes.- - - - - - - - - - ranking = 0.5keywords = black (Clic here for more details about this article) |
| | Next -> |