Which occupational lung disease is associated with carbon-laden macrophages (anthracosis)?

• A. Coal miner's pneumoconiosis
• B. Silicosis
• C. Asbestosis
• D. Berylliosis

Answer: (A)

Carbon-laden macrophages reflect inhalation of carbon-rich dust, with the pigment deposited in alveolar macrophages as they phagocytose the particles. When this occurs in workers exposed to coal dust, it points to coal workers’ pneumoconiosis (black lung disease). The disease spectrum ranges from simple carbon-laden macules to progressive massive fibrosis, and patients may have cough and dyspnea as it progresses.

In contrast, silicosis involves silica exposure with silicotic nodules and characteristic birefringent crystals; asbestosis shows ferruginous bodies and pleural changes; berylliosis causes noncaseating granulomas.