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Lung disease 35 years after aspiration of activated charcoal in combination with pulmonary lymphangioleiomyomatosis. A histological and clinicopathological study with scanning electron microscopic evaluation and element analysis

Lookup NU author(s): Professor Johannes Attems


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Activated charcoal provides effective treatment for most toxic ingestions. Accidental aspiration of activated charcoal is rare. Previously, there have been a few single cases reported on charcoal-related pulmonary complications. We describe an unusual case of pulmonary lesions 35 years after accidental aspiration of activated charcoal. The 38-year-old female patient presented with recurrent pneumothorax. A routinely performed chest roentgenogram revealed pulmonary lesions, highly suggestive to lymphangioleiomyomatosis (LAM). Histopathological investigation of the lung tissue demonstrated some features of LAM but showed prominent pneumoconiotic lesions with cystic tissue destruction. The pneumoconiotic reaction was characterized by prominent black deposits accompanied by foreign-body granuloma formation and minimal fibrosis. Scanning electron microscopic investigation of these deposits showed particles measuring up to 300 microm in greatest diameter. Energy-dispersive X-ray spectra of these particles revealed carbon-rich material, presumably charcoal. The aspiration event was confirmed by the clinical history. To our knowledge, this is the first report not only on a long-term follow-up after aspiration of activated charcoal but also on charcoal-related pulmonary lesions in combination with LAM.

Publication metadata

Author(s): Huber M, Pohl W, Reinisch G, Attems J, Pescosta S, Lintner F

Publication type: Article

Publication status: Published

Journal: Virchows Archiv

Year: 2006

Volume: 449

Issue: 2

Pages: 225-229

ISSN (print): 0945-6317

ISSN (electronic): 1432-2307

Publisher: Springer


DOI: 10.1007/s00428-006-0236-z

Notes: Huber, M Pohl, W Reinisch, G Attems, J Pescosta, S Lintner, F Case Reports Germany Virchows Archiv : an international journal of pathology Virchows Arch. 2006 Aug;449(2):225-9. Epub 2006 Jun 15.


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