Lung - nontumor
Pneumoconiosis
Coal workers' pneumoconiosis / progressive massive fibrosis

Author: Elliot Weisenberg, M.D. (see Authors page)

Revised: 22 March 2017, last major update September 2011

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed search: coal workers pneumoconiosis [title] OR progressive massive fibrosis [title]

Cite this page: Coal workers' pneumoconiosis / progressive massive fibrosis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/lungnontumorcoalworker.html. Accessed August 17th, 2017.
Definition / general
  • Incidence declining due to dust reduction measures

Simple coal workers' pneumoconiosis (CWP):
  • Patients have coal macules (1 - 2 mm collections of carbon laden macrophages) and coal nodules (coal macules and fibrosis) scattered throughout lung, more in upper lobe and upper lower lobe, near respiratory bronchioles
  • Usually minimal symptoms but 10% develop progressive massive fibrosis

Progressive massive fibrosis:
  • Also called complicated coal workers' pneumoconiosis
  • Intensely blackened scars > 2 cm, multiple and containing dense collagen and pigment
  • Center of lesion may be necrotic due to ischemia
  • Associated with pulmonary hypertension and cor pulmonale
  • May progress even if dust exposure ceases
  • Due to any pneumoconiosis, although most common in CWP and silicosis
  • Associated with increased incidence of clinical tuberculosis, chronic bronchitis and emphysema and independent of smoking
  • In isolation, not appear to increase the risk of lung cancer

Caplan syndrome:
  • Rheumatoid arthritis and pneumoconiosis cause rapidly developing nodular pulmonary lesions showing central necrosis surrounded by collagen, fibroblasts and macrophages (similar to rheumatoid nodules)
  • Associated with exposure to coal, asbestosis and silica dust
Microscopic (histologic) images

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Coal workers' pneumoconiosis