The first described case of occupational anthracofibrosis in the USA

Middle Lobe Syndrome Associated with Bronchial Anthracofibrosis

Bronchial anthracofibrosis has been defined as airway narrowing associated with dark pigmentation on bronchoscopy without an appropriate history of pneumoconiosis or smoking. We present a case of a 67-year-old, non-smoking female patient who was referred to our clinic for two years of persistent cough. Spirometry was within normal limits. Radiological evaluation showed right middle lobe atelectasis and positron emission tomography-positive mediastinal lymph nodes. Bronchoscopy revealed black airway discoloration and distortions. In conclusion, we propose monthly radiological controls before an invasive procedure in such cases if a strong suspicion of malignancy/tuberculosis is not present.

Domestic mixed-dust pneumoconiosis: A case report and literature review

Background

Mixed-dust pneumoconiosis (MDP) is a controversial disease with respect to diagnostic criteria. Usually, it is regarded as an occupational disease, but cases due to domestic exposure have been reported. In domestic settings, different dust sources may contribute individually or collectively to the pathogenesis.

Case presentation

A 56-year-old woman presented with chest nodularity on chest X-ray examination that had not resolved after 6 months of tuberculosis (TB) treatment. Her history showed significant exposure to mixed dusts caused by grinding grains with stones and the use of biomass fuel.

Conclusion

In residential settings, sufficient exposure to a variety of dusts, primarily silica-based dusts as well as those containing other less-fibrogenic materials, such as carbon, silicates and iron, have been shown to cause mixed-dust pneumoconiosis. In settings where the incidence of TB is very high, such as South Africa, the diagnosis of MDP might be overlooked due to the similarities of both diseases in their radiological presentations, especially when a detailed history of domestic exposure is omitted.