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Pathology · Cell injury and adaptation: acquired pigmentation
Sample itemA retired coal miner has a blackened lung and hilar nodes. Macrophages laden with black granules are seen along lymphatics. Which pigment is this?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Inhaled carbon (anthracotic pigment)
Anthracosis is the accumulation of inhaled carbon in alveolar macrophages, which carry it to lymphatics and regional nodes. It is usually harmless unless combined with dust that causes fibrosis, as in coal workers' pneumoconiosis.
Option by option
A. Inhaled carbon (anthracotic pigment) (correct)
Correct. Black granules within macrophages in a coal miner are inhaled carbon.
B. Melanin from melanocytes
Melanin is made by melanocytes and does not arise from inhalation.
C. Haemosiderin from red cell breakdown
Haemosiderin is golden-brown and stains with Prussian blue.
D. Lipofuscin from lipid peroxidation
Lipofuscin is a brown wear-and-tear pigment in ageing heart, liver and brain.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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