FIRST CASE REPORT OF ANCA-ASSOCIATED VASCULITIS AND ANTHRACOSIS COEXISTENCE

Authors

  • Emrah Dogan Muğla Sıtkı Koçman University
  • Ozan Kandemir Muğla Sıtkı Koçman University, Faculty of Medicine, Nuclear Medicine
  • Özge Oral Tapan Muğla Sıtkı Koçman University, Faculty of Medicine, Pulmonology
  • Utku Tapan Muğla Sıtkı Koçman University, Faculty of Medicine, Pulmonology
  • Sabri Serhan Olcay Muğla Sıtkı Koçman University, Faculty of Medicine, Pulmonology
  • Özgür İlhan Çelik Muğla Sıtkı Koçman University, Faculty of Medicine, Pathology
  • Marwa Mouline Doğan Muğla Sıtkı Koçman University, Faculty of Medicine

DOI:

https://doi.org/10.55519/JAMC-03-11529

Keywords:

Anthracosis, vasculitis, computed tomography, PET CT

Abstract

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.

Author Biographies

Ozan Kandemir, Muğla Sıtkı Koçman University, Faculty of Medicine, Nuclear Medicine

Muğla Sıtkı Koçman University, Faculty of Medicine, Department of Nuclear Medicine, Mugla/Turkey Call phone; +5066619794 E-mail: ozankandemir@mu.edu.tr Address: Muğla Education and Research Hospital Orcid Number: 0000-0003-3978-1222

Özge Oral Tapan, Muğla Sıtkı Koçman University, Faculty of Medicine, Pulmonology

Muğla Sıtkı Koçman University, Faculty of Medicine, Department of Pulmonology, Mugla/Turkey Call phone;+905058963474 E-mail: ozgeeoral@hotmail.com Address: Muğla Education and Research Hospital/ Pulmonology Orcid Number: 0000-0003-1499-3747

Utku Tapan, Muğla Sıtkı Koçman University, Faculty of Medicine, Pulmonology

Assistant Professor M.D., Muğla Sıtkı Koçman University, Faculty of medicine, Department of Pulmonology, Mentese/Mugla/Turkey.Callphone; +905052388841 Email: dr.utku.tapan@yahoo.com. Orcid Number: 0000-0002-2808-9233

Sabri Serhan Olcay, Muğla Sıtkı Koçman University, Faculty of Medicine, Pulmonology

Assistant Professor M.D., Muğla Sıtkı Koçman University, Faculty of medicine, Department of Pulmonology, Mentese/Mugla/Turkey.Callphone; +905057578329 Email: serhanolcay@mu.edu.tr Orcid Number: 0000-0002-3737-5813

Özgür İlhan Çelik, Muğla Sıtkı Koçman University, Faculty of Medicine, Pathology

Dr. Özgür İlhan Çelik  Associate Professor M.D., Muğla Sıtkı Koçman University, Faculty of medicine, Department of Patholohy, Mentese/Mugla/Turkey.Callphone; +905063058343 Email: ozgurilhancelik@mu.edu.tr Orcid Number: 0000-0002-3549-822X

Marwa Mouline Doğan, Muğla Sıtkı Koçman University, Faculty of Medicine

Dr. Marwa Mouline Dogan, Muğla Sıtkı Koçman University, Faculty of Medicine, Cardiolog, Mugla/Turkey Call phone; +905457134499 E-mail: dr.m.mouline@gmail.com Address: Muğla Education and Research Hospital Orcid Number: 0000-0002-3401-895X

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

2023-07-09