OBJECTIVETo explore the integrative quantitative index of the extent of pneumoconiotic changes by dusts and to evaluate the extent of pulmonary injury by the dusts containing different contents of free silica.

METHODSIn accordance with the morphometric principle, the areas of each kind of pathologic changes in the lung tissue sections of pneumoconiosis model were measured by utilizing a computer-aided graphic analyzer, and the volume density of each pathologic change and the value of pulmonary injury by dust(VPID) were calculated. Meanwhile the extent of pulmonary injury were compared among the rat groups treated with the dusts containing different contents of free silica.

RESULTSThere were significant differences among each groups in the volume density of some pathologic changes in the same exposed periods. There were significant correlation between VPID and the content of free silica dust or the lung collagen content (r = 0.535-0.849, P < 0.005 or P < 0.01). Furthermore, the degree of cor relationship of VPID with both of the latter were higher than the sum of unweighted volume density of the various pathologic changes in lung.

CONCLUSIONIt is suitable, reasonable and simple to use VPID an index to indicate the extent of pulmonary injury by dust and to diagnose pneumoconiosis in pathology, and the extent of pulmonary injury by dust may be aggravated with the increasing of the content of free silica.

Animals ; Dust ; Lung ; pathology ; Pneumoconiosis ; pathology ; Rats ; Silicon Dioxide ; toxicity

OBJECTIVETo study the pathological characteristics and the morphological changes of alumina pneumoconiosis.

METHODSThe pathological observation and analysis were performed in lungs of five autopsies with alumina pneumoconiosis.

RESULTSThe early common pathological change of alumina pneumoconiosis was the dust spots. The dust fibrosis had two forms, one was the non-focal fibrous proliferation of interstitial space, the other was the proliferation of inner-dust-spot fibrosis that finally developed into non-typical pneumoconiosis nodules.

CONCLUSIONThe pathological characteristics of the alumina pneumoconiosis may not be all the same to those of aluminium and aluminium oxide pneumoconiosis. Alumina pneumoconiosis is a complex pneumoconiosis. The typical pathological changes are the dust-spot emphysema and dust fibrosis of interstitial tissue. Infection in lung and complication of lung tumor, especially pneumo-tubercolosis would promote dust fibrosis. The pleural thickening, the relationship between lung cancer and alumina dust should be taken seriously.

Aluminum Oxide ; adverse effects ; Autopsy ; Humans ; Lung ; pathology ; Pneumoconiosis ; pathology

Humans ; Lung ; pathology ; Physical Examination ; Pneumoconiosis ; diagnosis ; Thoracotomy

Lung ; pathology ; Pneumoconiosis ; microbiology ; Pseudomonas Infections ; microbiology ; Pseudomonas aeruginosa

Pneumoconiosis is characterized by chronic lung inflammation and fibrosis, and inflammation can promote pulmonary fibrosis, which in turn leads to pneumoconiosis. When a large shadow with a long diameter of not less than 2 cm and a short diameter of not less than 1 cm appears in the lung, it can be classified as stage Ⅲ pneumoconiosis. This paper reports a case of stage Ⅲ pneumoconiosis with a large shadow in the upper right lung accompanied by burr-like changes misdiagnosed as lung cancer by CT examination.When the large shadow lesions in patients with pneumoconiosis and lung cancer are difficult to distinguish on CT, an additional MRI examination, particularly T(2)W imaging sequence is useful sequence for identifying the two.
Humans ; Pneumoconiosis/pathology* ; Lung/pathology* ; Lung Neoplasms/pathology* ; Pulmonary Fibrosis/pathology* ; Diagnostic Errors

OBJECTIVETo study the pathological features of progressive massive fibrosis (PMF) in the lung tissues of patients with coal workers' pneumoconiosis (CWP).

METHODSA retrospective analysis was made on the autopsies from 8 patients with CWP, which were observed under a microscope by HE staining, given their occupational history.

RESULTSThe age of 8 cases ranged 47-71 years (mean, 59.9 years), and their dust exposure time was 18-32 years (mean, 25.1 years). All the 8 cases were complicated by chronic bronchitis as well as emphysema, 7 cases by pulmonary heart disease, and 4 cases by pulmonary tuberculosis. In this group of patients, PMF was mainly distributed in the hilum and the upper lobe of the lung, including 7 cases of nodular fusion type and 1 case of PMF type. The collagen fibers around PMF extended radially and destroyed its surrounding tissue.

CONCLUSIONNodular fusion type is the main form of PMF in the lung tissues of CWP patients. It has a progressive and destructive process, which is the manifestation of advanced CWP.

Aged ; Anthracosis ; pathology ; Coal Mining ; Dust ; Humans ; Lung ; pathology ; Male ; Middle Aged ; Pneumoconiosis ; pathology ; Retrospective Studies

Objective: To investigate the clinicopathological characteristics of occupational lung diseases, to reduce the missed diagnoses and misdiagnoses of the diseases and to help standardize the diagnosis and treatment of these patients. Methods: A total of 4 813 lung biopsy specimens (including 1 935 consultation cases) collected at the Department of Pathology, Nanjing Drum Tower Hospital, Nanjing, China from January 1st, 2017 to December 31th, 2019 were retrospectively analyzed. Among them, 126 cases of occupational lung diseases were confirmed with clinical-radiological-pathological diagnosis. Special staining, PCR and scanning electron microscopy were also used to rule out the major differential diagnoses. Results: The 126 patients with occupational lung diseases included 102 males and 24 females. All of them had a history of exposure to occupational risk factor(s). Morphologically, 68.3% (86/126) of the cases mainly showed pulmonary fibrotic nodules, dust plaque formation or carbon end deposition in pulmonary parenchyma. 16.7% (21/126) of the cases mainly showed welding smoke particle deposition in the alveolar cavity and lung interstitium while 15.1% (19/126) of the cases showed granulomas with fibrous tissue hyperplasia, alveolar protein deposition or giant cell interstitial pneumonia. The qualitative and semi-quantitative analyses of residual dust components in the lung under scanning electron microscope were helpful for the diagnosis of welder's pneumoconiosis and hard metal lung disease. Conclusions: The morphological characteristics of lung biopsy tissue are important reference basis for the clinicopathological diagnosis and differential diagnosis of occupational lung diseases. Recognizing the characteristic morphology and proper use of auxiliary examination are the key to an accurate diagnosis of occupational lung diseases on biopsy specimens.
Male ; Female ; Humans ; Retrospective Studies ; Pneumoconiosis/pathology* ; Lung/pathology* ; Dust ; Pneumonia, Viral/pathology* ; Biopsy

Adult ; Biopsy ; methods ; Bronchoscopy ; Humans ; Lung ; pathology ; Male ; Middle Aged ; Pneumoconiosis ; diagnosis ; pathology

OBJECTIVETo explore the role of transbronchial lung biopsy (TBLB) in pathologic diagnosis of pneumoconiosis.

METHODSIn our hospital during May 2011 and Sep 2011, the TBLB samples from 35 cases occupationally exposed to dusts were compared with the video-assisted thoracoscopic surgery or lobectomy samples from 27 cases not exposed to dusts for pathological indexes, including fibrotic proliferation, nodule or nodule-like, dust deposition and needle-shaped birefringent particles.

RESULTSIn group exposed to dusts, there were 6 cases (17.1%) with the moderate dust deposition and 28 cases (80.0%) with fibrotic proliferation. But in group not exposed to dusts, there were 0 case with the moderate dust deposition and 11 cases (40.0%) with fibrotic proliferation. There were significant differences between two groups (P < 0.05). In group exposed to dusts, there were 6 cases (17.1%) with Nodules-like and needle-shaped birefringent particles, but in group not exposed to dusts, there was 0 case with Nodules-like and needle-shaped birefringent particles.

CONCLUSIONTBLB could provide the evidence of pathological changes in lung tissue induced by dusts, and TBLB play an important role in pneumoconiosis diagnosis.

Adult ; Aged ; Biopsy ; methods ; Dust ; Female ; Humans ; Lung ; pathology ; Male ; Middle Aged ; Pneumoconiosis ; diagnosis ; pathology

OBJECTIVETo evaluate the role of transbronchial lung biopsy (TBLB) pathology in pneumoconiosis diagnosis.

METHODSDuring Jan 2003 to Jun 2010 in our hospital. 418 patients exposed to dusts were examined with TBLB. The chest radiographs of all subjects showed the pneumoconiosis-like opacities. Because the dust property or accumulated doses didn't match with abnormality on chest radiographs or there were no a series of chest radiographs, it was required for subjects to perform the TBLB for diagnosis. Three hundred seventy nine cases with satisfying samples served as the study subjects. The dust deposition, fibrosis and birefringent particles were found in TBLB pathological examinations. From May 2005, the Prussian blue iron reaction test was conducted on the TBLB samples. A panel made pneumoconiosis diagnosis according to GBZ 70-2002 and GBZ 70-2009 Pneumoconiosis Diagnostic Criteria, consulting subjects' accounts and pathologic results.

RESULTSAmong 379 subjects, 376 cases (99.2%) showed the lung interstitial fibrosis, 228 cases (60.2%) demonstrated the dust deposition, 111 cases (29.3%) expressed the birefringent particles by polarized light microscopy. Birefringent particles positive rate was 37.8% (62/164) in 164 patients exposed to either silica or potter dusts or cement dusts or coal-silica dusts or foundry dusts, which was much higher than that (22.7%, 49/215) in patients exposed to other dusts (welding fume or asbestos or aluminum dusts) (P < 0.05). The positive rate of Prussian blue iron reaction in 177 patients exposed to welding fume or burnishing dusts was 53.1% (94/177), which was significantly higher than that (23.2%, 13/56) in patients exposed to other dusts (cement dusts, casting dusts or silica) (P < 0.001). There were no significantly differences in rates of lung fibrosis, dust deposition and birefringent particles between pneumoconiosis and none-pneumoconiosis subjects. The rate of lung fibrosis in pneumoconiosis cases was significantly higher than that in non- pneumoconiosis cases (P < 0.05).

CONCLUSIONTBLB could provide the evidence of exposure to dusts and pathological changes, which may be useful to the pneumoconiosis diagnosis.

Biopsy ; methods ; Bronchi ; Bronchoscopy ; Female ; Humans ; Lung ; pathology ; Male ; Middle Aged ; Pneumoconiosis ; diagnosis ; pathology