FIRST CASE REPORT OF ANCA-ASSOCIATED VASCULITIS AND ANTHRACOSIS COEXISTENCE
DOI:
https://doi.org/10.55519/JAMC-03-11529Keywords:
Anthracosis, vasculitis, computed tomography, PET CTAbstract
Anthracosis is a type of mild pneumoconiosis secondary to harmless carbon dust deposits. Although anthracosis was previously associated with inhaled coal particles, such as coal workers' pneumoconiosis, this hypothesis was later abandoned; pathology has been associated with inhaled dust particles. Our paper is the first case report of ANCA-associated vasculitis and anthracosis coexistence. In addition, it aims to highlight that histopathologically proven anthracotic granulomatous nodules can show high FDG uptake in PET/CT contrary to expectation. We present a case of a 73-year-old male with p-ANCA-associated vasculitis and anthracotic lung nodules accompanied by radiological and clinical findings. The patient got diagnosis with p-ANCA-associated vasculitis with serological and rheumatological tests. Atypically, the clinical findings of the patient were weak (No dyspnoea, cough or additional pulmonary complaints). Nodules were present on X-ray graphics and nodules’ contours were irregular on CT. On PET/CT, SUV values of the nodules were high [12 kBq/mL]. Histopathological specimens showed multiple lung granulomas including anthracosis particles. Until performing the biopsy, we could not exclude the possibility of malignancy. Conclusion: When lung involvement of vasculitis is superimposed by anthracosis, it can create granulomas with high SUV values. The relationship between anthracosis and parenchymal lung diseases is a current topic and many recently published papers are present on this subject. To the best of our knowledge, our paper is the first paper showing the relationship between parenchymal involvement of vasculitis and anthracosis in the literature. Environmental pollution and dust particles are the known reasons for anthracosis particles in the nodules. It is open to future research on whether air pollution triggers new atypical cases or not.References
Mirsadraee M. Anthracosis of the lungs: aetiology, clinical manifestations and diagnosis: a review. Tanaffos 2014;13(4):1–13.
Deepak J, Kenaa B. Caplan's Syndrome with a twist. Int J Clin Case Rep Rev 2020;2(1):10.
Mirsadraee MH, Asnashari AK, Attaran DM. Tuberculosis in patients with anthracosis of lung underlying mechanism or superimposed disease. Iran Red Crescent Med J 2011;13(9):670–73.
Zhai L, Yu W. The co-occurrence of anthracosis with interstitial lung disease. Sarcoidosis Vasc Diffuse Lung Dis 2022;39(2):e2022012.
Donaldson K, Wallace WA, Elliot TA, Henry C. James Craufurd Gregory. 19th century Scottish physicians, and the link between occupation as a coal miner and lung disease. J R Coll Physicians Edinb 2017;47(3):296–302.
Takır HB, Tokyay DA, Güven AAÖ, Öztaş S, Yıldız T, Hacıömeroğlu O, et al. A Case of Pulmonary Tuberculosis with Anthracosis Presenting as Recurrent Pneumonia. Turk Toraks Derg 2019;20:406.
Rozenberg D, Shapera S. What to do with all of these lung nodules? Can Respir J 2014;21(3):e52–4.
Shinagare AB, Cunto-Amesty G, Fennessy FM. Multiple inflammatory nodules: a differential diagnosis of new pulmonary nodules in oncology patients. Cancer Imaging 2011;10(1):205–8.
Das J, Layton B, Lamb H, Sinnott N, Leahy BC. A case of pulmonary Serratia marcescens granuloma radiologically mimicking metastatic malignancy and tuberculosis infection. Scott Med J 2015;60(4):254–8.
Raju S, Ghosh S, Mehta AC. Chest CT Signs in Pulmonary Disease: A Pictorial Review. Chest 2017;151(6):1356–74.
Belperio JA, Shaikh F, Abtin FG, Fishbein MC, Weigt SS, Saggar R, et al. Diagnosis and Treatment of Pulmonary Sarcoidosis: A Review. JAMA 2022;327(9):856–67.
Radice A, Sinico RA. Antineutrophil cytoplasmic antibodies (ANCA). Autoimmunity 2005;38(1):93–103.
Venade G, Figueiredo C, Almeida C, Oliveira N, Matos LC. Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome). Rev Assoc Med Bras (1992) 2020;66(7):904–7.
Suzuki A, Sakamoto S, Kurosaki, Kurihara Y, Satoh K, Usui Y, et al. Chest High-Resolution CT Findings of Microscopic Polyangiitis: A Japanese First Nationwide Prospective Cohort Study. AJR Am J Roentgenol 2019;213(1):104–14.
Oshita H, Matsumoto H, Hoshino T, Omori K, Okamoto N, Awaya Y. Wegener's granulomatosis in which rheumatoid factor was useful for evaluating the disease status: a case report. Cases J 2009;2:6323.
Noritake DT, Weiner SR, Bassett LW, Paulus HE, Weisbart R. Rheumatic manifestations of
Wegener's granulomatosis. J Rheumatol 1987;14(5):949–51.
Additional Files
Published
Issue
Section
License
Copyright (c) 2023 Emrah Dogan, Ozan Kandemir, Özge Oral Tapan, Utku Tapan, Sabri Serhan Olcay, Özgür İlhan Çelik, Marwa Mouline Doğan
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
