Abstract

A 44-year-old woman was admitted to the hospital for exploration of an abnormal chest shadow which was pointed out at a clinical survey. Chest CT revealed two tumorous shadows less than 1cm in diameter adjacent to the lateral pleura of right lower lobe. An operation was performed. Two lesions black in color were seen on the surface of right lower lobe and a partial excision of the lung was conducted under thoracoscopic surgery. Histopathologically, in both two nodules, granulation tissues comprizing of colonies of coal dust phagocytic macrophages and lymphocytes were formed. The definite diagnosis of pulmonary anthracosis was made. Pulmonary anthracosis is commonly seen in adults, but the disease which forms a tumor to demand operation is relatively rare. The patient did not have any histories of smoking nor working to treat coal dust, but she had worked at ironworks where she exposed to a low concentration of dust that might cause deposit of coal dust. The disease presents difficulty in differentiation from pulmonary cancer on imaging methods. For making the definite diagnosis, thoracoscopic operation would be useful.

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