Coal workers' pneumoconiosis
Summary
Restrictive interstitial lung disease from inhalation of coal dust, with carbon-laden macrophages forming coal macules in upper lobes. May progress to massive fibrosis ('black lung').
Detail
Coal workers' pneumoconiosis (CWP) is caused by chronic inhalation of carbon dust; alveolar macrophages engulf coal particles and aggregate around respiratory bronchioles forming 'coal macules' predominantly in the upper lobes. Simple CWP is often asymptomatic with small upper-lobe nodules; complicated CWP (progressive massive fibrosis) shows large fibrotic masses >1 cm, causing dyspnea, cor pulmonale, and restrictive PFTs. Caplan syndrome = CWP (or silicosis) + rheumatoid arthritis with intrapulmonary nodules. Anthracosis is asymptomatic carbon deposition seen in urban dwellers/smokers, not a true pneumoconiosis. Unlike silicosis, CWP does not increase TB risk substantially. Boards: upper-lobe nodules in a coal miner + RA = Caplan.
Sources
- First Aid for USMLE Step 1 2024
- Pathoma
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