PMC7227742_01
HRCT Chest a) axial and b) coronal sections showing calcified mediastinal and hilar nodes with confluent consolidation and cicatrization in bilateral lungs with foci of calcification and confluent centrilobular nodules with areas of ground glass opacity in bilateral lungs likely pneumoconiosis. Right pleural effusion is seen
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F1
Chylous fluid from the intercostal drain-milky with a reddish-orange hue
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F2
A right-sided intercostal drain was inserted and this drained fluid which was opaque with a reddish hue [Figure 2].
Photomicrograph of CT-guided lung biopsy shows: (a) Fibrosis with dense deposition of anthracotic pigment (anthracofibrosis). Fibrosis is highlighted by Massan trichrome stain (MT stain, blue color). (c and d) Special histochemical stain, periodic acid Schiff with diastase resistant (PAS D) reveals presence of granular proteinaceous material in the alveolar lumen suggesting alveolar proteinosis
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F3
The transthoracic lung biopsy [Figure 3] showed revealed anthracofibrosis with alveolar proteinosis.