Lymph nodes & spleen, nonlymphoma

Pigment / foreign material


Last author update: 1 February 2014
Last staff update: 18 July 2022

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PubMed Search: anthracosis [title] lymph node

Jayalakshmi Balakrishna, M.D.
Page views in 2022: 5,353
Page views in 2023 to date: 6,159
Cite this page: Balakrishna J, Sharabi A. Anthracosis. website. Accessed November 29th, 2023.
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)
  • Very common
  • 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)
  • 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:
Missing Image

Abundant anthracotic pigment

Positive stains
  • CD68 (macrophages containing pigment)
Differential diagnosis
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