TB is associated with which of the following:

Ans: c (Silicosis) Ref: Harrison's, 16th ed,p. 1523; 17th ed,p. 1614TB may be associated with silicosis. In silicosis TB may modify the silicotic process with ensuing caseation and calcification.PneumoconiosisIt is described as nonneoplastic lung reactions induced by inhaled organic as well as inorganic particulates, chemical fumes and vapours. Eg: Silicosis, asbestosis, coal workers pneumoconiosis, berylliosis.SilicosisCaused by crystalline silicon dioxide (silica), quartz particlesSilica is the most fibrogenic dust.Occupational exposures in - mining, stonecutting, glass and cement manufacturingPathological featuresFibrotic nodules are seen in the upper lobe. It may also lead to progressive massive fibrosis.Radiological featuresIt shows small rounded opacities in upper lobeHilar adenopathy is seen - egg shell calcification in these nodesPatient with silicosis have a greater risk of acquiring Mycobacterium tuberculosis and atypical mycobacterial infectionsSilicosis progresses even when exposure to dust ceases.Acute silicosis-An intense exposure to very fine crystalline silica dust for just 10 months can cause acute silicosis. It shows profuse miliary infiltration and it is rapidly fatalAsbestosis- explained earlierCoal workers pneumoconiosisCaused by coal particlesOccupational exposure in - miners (mainly anthracite miners)Pathological featuresSimple type - coal macules (1 -2 mm) are seen around bronchioles. Coal macules are carbon laden macrophages with collagen fibres.Progressive massive fibrosis - Fibrotic nodules are seen with black necrotic fluid. Multiple intensely blackened scars (>2 cm) may be seen.Radiological featuresGenerally confined to upper lobe, small irregular opacities (reticular pattern) are present which may develop into nodules (nodular pattern)Calcification is not generally seen.Caplan syndrome - Seropositive rheumatoid arthritis coexists with rounded fibrotic nodules (Pneumoconiosis) of 0.5-5 cm in diameter. These nodules are mainly in the periphery of the lung fields.BerylliosisCaused by exposure to beryllium in ceramics industries and high technology electronics.It causes a chronic granulomatous type of disease, the granuloma resembling that of sarcoidosis (without caseation).Silicosis - upper lobeTB - upper lobeCoal workers pneumoconiosis - upper lobeAsbestosis - lower lobe