[Bronchial anthracosis and pulmonary mica overload].
BACKGROUND
The discovery of anthracotic plaques generally suggests either a history of tuberculosis or occupational exposure to dust. Other etiologies should, however, be considered.


METHODS
A 60-year-old Iranian woman presented with a history of dyspnoea and with chest radiography demonstrating calcified hilar lymph nodes and interstitial lung disease. Pulmonary function tests revealed airway obstruction. A diffuse bronchial inflammatory appearance accompanied by anthracotic plaques was found at bronchoscopy, which prompted transmission electron microscopy analysis of non-fibrous mineral particles in the bronchoalveolar lavage fluid (BALF). This demonstrated the presence of an alveolar particle count greater than 10(7) particles/ml (p/ml), significantly more than that found in 42 BALF samples taken from controls without a history of occupational dust exposure (4,4.10(5) p/ml). Furthermore, the analysis also revealed an abnormally elevated proportion of mica particles (64%). Two other individuals, a 68 year-old Moroccan woman and a 70-year-old Algerian woman, who had anthracotic plaques, but no radiological evidence of interstitial lung disease, also underwent mineral analysis of BALF. Neither were found to have a raised alveolar particle count, but the mineral profile showed an abnormally elevated proportion of micas (62%) for one patient, and silica crystalline (40%) as well as micas (32%) for the other patient.


CONCLUSIONS
Even if mica is present in 30 to 90% of the BALF, the results observed in these three patients raises the possibility of non-occupational environmental exposure and that anthracotic plaques might be associated with domestic pollution.
Mulliez
Ph
P
Service de Pneumologie, Hôpital Saint Philibert, 59462 Lomme Cedex, France. mulliez.philippe@ghicl.fupl.asso.fr
Billon-Galland
M-A
MA
Dansin
E
E
Janson
X
X
Plisson
J-P
JP
D000368:Aged; D000462:Algeria / Q000208:ethnology; D000538:Aluminum Silicates / Q000032:analysis*; D000874:Anthracosilicosis / Q000175:diagnosis* / Q000209:etiology*; D001706:Biopsy; D001991:Bronchitis / Q000175:diagnosis* / Q000209:etiology*; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry*; D001999:Bronchoscopy; D016022:Case-Control Studies; D004417:Dyspnea / Q000209:etiology; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D005602:France; D006801:Humans; D007492:Iran / Q000208:ethnology; D008854:Microscopy, Electron; D008875:Middle Aged; D009018:Morocco / Q000208:ethnology; D012822:Silicon Dioxide / Q000032:analysis; D014057:Tomography, X-Ray Computed
D000538:Aluminum Silicates; D012822:Silicon Dioxide; C011934:mica