A retired coal mine worker undergoes chest radiography for an insurance evaluation. He is asymptomatic. The radiograph shows small round opacities in the upper zones. Histology of such lesions would most likely show:
- A Silicotic nodules with concentric whorls of hyalinized collagen and birefringent particles
- B Noncaseating granulomas with asteroid bodies
- C Coal-dust macules around respiratory bronchioles with carbon-pigmented macrophages ✓
- D Ferruginous bodies surrounded by interstitial fibrosis
Correct answer: C. Coal-dust macules around respiratory bronchioles with carbon-pigmented macrophages
Explanation
Simple coal workers pneumoconiosis is characterized by coal-dust macules and nodules, collections of carbon-laden macrophages around respiratory bronchioles in the upper lobes, often with centrilobular emphysema. It is radiologically similar to silicosis but histologically distinct: the silicotic nodule has concentric hyalinized collagen whorls and is more fibrogenic. Noncaseating granulomas suggest sarcoidosis and ferruginous bodies indicate asbestosis.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.