Which statement about coal workers pneumoconiosis is correct?

• A The principal lesion is a granuloma with central necrosis
• B It carries the same degree of functional impairment as silicosis at equivalent radiographic stage
• C It predisposes strongly to tuberculosis, unlike silicosis
• D The characteristic lesion is the coal dust macule centered on respiratory bronchioles in the upper lobes ✓

Explanation

Simple coal workers pneumoconiosis is marked by coal macules and nodules, collections of dust-laden macrophages around respiratory bronchioles, predominantly upper lobe and upper zone, often with focal emphysema. Simple disease causes little functional impairment compared with silicosis at similar radiographic extent. It is silicosis, not coal workers pneumoconiosis, that carries a well-established association with tuberculosis.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

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