The Curious Case of the Black Buboes
Arunava Saha1, Shihla Shireen Kanamgode1, Shari Mitra2
1Internal Medicine, Saint Vincent Hospital, Worcester, USA.
Cureus
|January 19, 2023
Summary
Nodal anthracosis, a rare condition involving carbon pigment in lymph nodes, can mimic serious diseases like cancer or infections. This case highlights its potential to cause systemic symptoms and widespread lymphadenopathy.
Area of Science:
- Pulmonology
- Pathology
- Oncology
Background:
- Anthracosis is typically an environmental lung disease from carbon deposition.
- Systemic involvement, though rare, can occur, presenting diagnostic challenges.
Observation:
- A 64-year-old male with a smoking history presented with B-symptoms and diffuse lymphadenopathy.
- Extensive imaging revealed widespread lymphadenopathy and pulmonary nodules.
- Initial workup for infections, autoimmune diseases, and malignancy was negative.
Findings:
- Mediastinal lymph node biopsy showed reactive hyperplasia with abundant anthracitic pigment, confirming nodal anthracosis.
- The patient exhibited PET-positive lymphadenopathy mimicking malignancy or infection.
- Symptoms resolved spontaneously within six weeks.
Implications:
- Nodal anthracosis is an infrequent but critical differential diagnosis for unexplained lymphadenopathy and systemic symptoms.
- It can mimic infectious, granulomatous, and malignant conditions, necessitating careful pathological examination.
- Awareness of this condition is crucial for accurate diagnosis in patients with potential biomass exposure.
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