Abstract
Lungs from 123 coalworkers coming to necropsy were examined to determine the association between dust related changes in the central lymph nodes and progressive massive fibrosis and secondary foci in the lung parenchyma. Increasingly extensive changes of the central nodes were scored macroscopically, the highest scores indicating erosion through the walls of adjacent bronchi or branches of the pulmonary artery or both. In 88 cases (mainly with extensive changes) microscopic assessment was also made. Increasingly extensive changes of central nodes were associated with the presence of progressive massive fibrosis in the lungs (p less than 0.001) and the presence of secondary foci in lungs without progressive massive fibrosis (p less than 0.03). Microscopic assessments agreed fairly well with macroscopic assessments, but tended to be assigned lower scores. A hypothesis for the pathogenesis of progressive massive fibrosis is proposed whereby dust, accumulating in central lymph nodes, leads eventually to spread through the capsule and rupture into bronchi or pulmonary vessels, thereby sending dust laden activated cells back into the lungs to produce progressive massive fibrosis. These preliminary results are consistent with the hypothesis but more detailed studies are required.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- CAPLAN A. Certain unusual radiological appearances in the chest of coal-miners suffering from rheumatoid arthritis. Thorax. 1953 Mar;8(1):29–37. doi: 10.1136/thx.8.1.29. [DOI] [PMC free article] [PubMed] [Google Scholar]
- COCHRANE A. L. The attack rate of progressive massive fibrosis. Br J Ind Med. 1962 Jan;19:52–64. doi: 10.1136/oem.19.1.52. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cockcroft A., Seal R. M., Wagner J. C., Lyons J. P., Ryder R., Andersson N. Post-mortem study of emphysema in coalworkers and non-coalworkers. Lancet. 1982 Sep 11;2(8298):600–603. doi: 10.1016/s0140-6736(82)90671-7. [DOI] [PubMed] [Google Scholar]
- KING E. J., MAGUIRE B. A., NAGELSCHMIDT G. Further studies of the dust in lungs of coal-miners. Br J Ind Med. 1956 Jan;13(1):9–23. doi: 10.1136/oem.13.1.9. [DOI] [PMC free article] [PubMed] [Google Scholar]
- MANN K. J. A radiological study of the relationship between tuberculosis and pneumokoniosis in coal miners. Thorax. 1951 Mar;6(1):43–55. doi: 10.1136/thx.6.1.43. [DOI] [PMC free article] [PubMed] [Google Scholar]
- WELLS A. L. Pulmonary vascular changes in coal-worker's pneumoconiosis. J Pathol Bacteriol. 1954 Oct;68(2):573–587. doi: 10.1002/path.1700680230. [DOI] [PubMed] [Google Scholar]
- Wagner J. C., Wusteman F. S., Edwards J. H., Hill R. J. The composition of massive lesions in coal miners. Thorax. 1975 Aug;30(4):382–388. doi: 10.1136/thx.30.4.382. [DOI] [PMC free article] [PubMed] [Google Scholar]