Carbon-laden macrophages in pleural fluid of crack smokers.
Carbon-laden macrophages in bronchoalveolar lavage have been noted to be associated with a history of crack smoking. We report herein the finding of carbon-laden macrophages in four cytological preparations of pleural fluid from two crack smokers. The etiology of the two patients' pleural effusions differed; neither had a bronchopleural fistula. Patient 1 had AIDS, Pneumocystis carinii pneumonia, and Kaposi's sarcoma of the right lung with an associated bilateral pleural effusion. Patient 2 was HIV seropositive, had pulmonary tuberculosis, hepatitis A, B, and C, cardiomyopathy, pulmonary embolism, and bilateral pleural effusions, the latter of which were probably due to cardio-pulmonary dysfunction. An additional two crack smokers with pleural effusions due to malignancy, one primary pulmonary adenocarcinoma and the other metastatic melanoma, did not have carbon-like material in their pleural fluid cytology. We hypothesize that intracellular accumulation of carbonaceous material in the lung parenchyma and pleural space occurs when normal clearance mechanisms are overwhelmed.
Singh
B
B
Department of Pathology, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA.
Greenebaum
E
E
Cole
R
R
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000328:Adult; D002244:Carbon / Q000032:analysis*; D009202:Cardiomyopathies / Q000150:complications; D016578:Crack Cocaine / Q000008:administration & dosage / Q000009:adverse effects*; D006679:HIV Seropositivity / Q000150:complications; D006506:Hepatitis A / Q000150:complications; D006509:Hepatitis B / Q000150:complications; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications; D008264:Macrophages / Q000737:chemistry*; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000209:etiology / Q000473:pathology*; D011020:Pneumonia, Pneumocystis / Q000150:complications; D012514:Sarcoma, Kaposi / Q000150:complications; D012907:Smoking; D014376:Tuberculosis / Q000150:complications
D016578:Crack Cocaine; D002244:Carbon