Breining H
Pathologe. 2003 Mar;24(2):98-102. doi: 10.1007/s00292-002-0571-z. Epub 2002 Dec 10.
Over a period of approximately 30 years we have compared the frequency of Miner's phthisis in the coal mining areas of Aachen and the Ruhr area of Essen and have investigated a total of approximately 600 lungs with silicosis. In cases of silicosis grades II-III and III we found liquefaction in 36% of the callosities but in cases of silicosis I-II and II in only 4-7%. Liquefaction of callosities, or phthisis atra, was found slightly more often in the Ruhr area than in the area of Aachen. If the liquefied silicotic material is expectorated from the bronchial tubes, a cavern-like cavity develops in the lungs, which clinically can often not be differentiated from a tuberculotic cavern. Sometimes silicotic material is transported via the blood vessels and dust particles could often be found microscopically in the liver, spleen or kidneys. In one patient we found silicotic material coming from the bronchial veins with development of arterial embolisms in peripheral arteries of the extremities and brain. The pathogenesis of callosity liquefaction is a consequence of disruption of the blood supply to the surrounding areas of the callosities. In some cases blood vessels in the centre of the callosities are destroyed so that the patient dies after severe haemoptysis.
在大约30年的时间里，我们比较了亚琛煤矿区和埃森鲁尔区矿工肺结核的发病率，并对总共约600例矽肺患者的肺部进行了研究。在II - III级和III级矽肺病例中，我们发现36%的硬结出现液化，但在I - II级和II级矽肺病例中，液化率仅为4 - 7%。硬结液化或干性肺结核在鲁尔区的发现频率略高于亚琛地区。如果液化的矽肺物质从支气管咳出，肺部会形成空洞样空腔，临床上常常无法与结核空洞区分开来。有时，矽肺物质会通过血管运输，在显微镜下常常能在肝脏、脾脏或肾脏中发现尘埃颗粒。在一名患者中，我们发现矽肺物质来自支气管静脉，并在四肢和脑部的外周动脉中形成动脉栓塞。硬结液化的发病机制是硬结周围区域血液供应中断的结果。在某些情况下，硬结中心的血管被破坏，患者会在严重咯血后死亡。
