Granulomatous involvement of the liver in anthracosilicosis

The authors reexamined 300 autopsies which were carried out from 1965 to 1983, on male subjects affected by pulmonary anthracosilicosis already diagnosed in vita and holders of pensions for invalidity allocated to them by the Istituto Nazionale Assicurazione Infortuni sul Lavoro. Their livers were reexamined and the specimens which contained agglomerates of at least 5 macrophages in phagocytic activity with dust particles and birefringent silica crystals were considered positive for a silicotic interstitial type involvement of the organ. Larger accumulations of macrophages in fibroelastic activity, including those with fibrohyaline evolution, were considered as silicotic granulomas. Only the incidence of the hepatic granulomatous types was analyzed and related to the severity of the disease, classified according to four types of increasing gravity: interstitial, nodular, confluent and massive. The statistical analysis of the data demonstrates that there is a close correlation between the gravity of pulmonary anthracosilicosis and hepatic involvement, less in interstitial and more in massive types; thus, it is dependent on the amount of silica. On the other hand, the granulomatous evolution following hepatic involvement is not correlated with the gravity of pulmonary anthracosilicosis; therefore, it is not dependent on the amount of silica but is an individual cellular response.