Lymph nodes & spleen, nonlymphoma
Pigment / foreign material
Anthracosis
Last author update: 1 February 2014
Last staff update: 18 July 2022
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PubMed Search: anthracosis [title] lymph node
Table of Contents
Definition / general | Epidemiology | Sites | Clinical features | Radiology description | Radiology images | Prognostic factors | Case reports | Treatment | Gross description | Microscopic (histologic) description | Cytology description | Cytology images | Positive stains | Differential diagnosis | Additional referencesCite this page: Balakrishna J, Sharabi A. Anthracosis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/lymphnodesanthracosis.html. Accessed April 23rd, 2024.
Definition / general
- Accumulation of carbon in lymph nodes, more commonly in intrapulmonary lymph nodes, due to coal dust, smoke or pollution
- May be associated with storiform pattern of histiocytes that resembles a neoplasm (Hum Pathol 1998;29:851)
- Associated with silica, although often no history of industrial exposure
- Associated with hyalinization in nodes of elderly Japanese (Histol Histopathol 2003;18:1169)
Epidemiology
- Very common
Sites
- Common in hilar and bronchial lymph nodes
Clinical features
- Enlargement of involved lymph nodes, prominent mediastinal lymphadenopathy is common
Radiology description
- Enlarged lymph nodes, especially mediastinal and bronchial lymph nodes
Radiology images
Images hosted on other servers:
Apical lung lesion
Increased uptake in left upper lobe
FDG PET/CT scan shows
high-grade metabolic activity
in right hilar soft tissue lesion
Prognostic factors
- Benign process with no significant clinical implications
Case reports
- 71 year old woman, with life-long exposure to soot from a wood cook stove, with anthracosis and large mediastinal mass with healed pulmonary tuberculosis (Clin Med Res 2010;8:99)
- Women who cooked over wood fires, with primary nodal anthracosis identified as a cause of FDG PET/CT positive mediastinal lymphadenopathy (Respiratory Medicine Case Reports 2013;10:48)
- A case of anthracosis presenting with mediastinal lymph nodes mimicking tuberculous lymphadenitis or malignancy (Eur J Intern Med 2003;14:444)
Treatment
- If significant enlargement, excision biopsy
Gross description
- Enlarged lymph nodes with firm dark brown to black cut surfaces
Microscopic (histologic) description
- Anthracotic macrophages in clusters and singly dispersed
- There may be storiform arrangement of spindle cells or granuloma like aggregates of macrophages
- Fine anthracotic pigment
- Also nodal hyaline scars and polarizable material suggestive of silica
Cytology description
- Cellular smears with a population of anthracotic macrophages that are both singly dispersed and in variously sized aggregates
- Variable foreign body type, multinucleated giant cells
- No necrosis or atypical cells
Cytology images
Images hosted on other servers:
Abundant anthracotic pigment
Positive stains
- CD68 (macrophages containing pigment)
Differential diagnosis
- Clinically resembles malignancy: lymphoma, metastasis
- Follicular dendritic cell tumor
- Kaposi sarcoma
- MFH
- Sarcoidosis
- Spindle cell melanoma
- Tuberculosis
Additional references
