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Coal workers' pneumoconiosis

Last author update: 1 September 2011

Last staff update: 22 February 2023

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PubMed Search: Coal workers pneumoconiosis OR progressive massive fibrosis

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Table of Contents

Definition / general | Radiology images | Gross images | Microscopic (histologic) images

Cite this page: Weisenberg E. Coal workers' pneumoconiosis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/lungnontumorcoalworker.html. Accessed April 17th, 2024.

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

Radiology images

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