Histologic changes: At higher magnification, one can see histiocytes that contain a large amount of black pigment; there is little fibrosis. The pigment should not be referred to as "anthracotic," which refers to anthracite coal. Derived from other types of smoke in the air, the deposits should simply be designated "black pigment." It becomes concentrated centrally as parenchyma collapses (see previous page). The bronchiole shows a constrictive bronchiolitis with a subepithelial inflammatory infiltrate separating the smooth muscle (arrow at top middle) from the epithelium. Note also the intimal thickening and narrowing of the artery (lower two arrows indicate the media).

Clinical summary Image 3

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