Anthracosilicosis is a term describing the concomitant exposure to silica and carbon from air pollution and smoke, causing a variable clinical presentation involving the respiratory system. It is almost exclusively encountered in the industrial setting, and the diagnosis rests on clinical criteria, findings obtained during history, and imaging studies.
Anthracosilicosis is very rarely described in the medical literature and the term was created as a combination of two separate disorders  :
Consequently, the clinical presentation of dyspnea, cough, and breathlessness is typically seen, but reports also show that melanoptysis (black-pigmented sputum) and chest pain might also be present .
Regardless of the type of occupational or environmental lung disease, a detailed patient history, and a thorough physical examination are the first and most important steps in the workup. Chronic respiratory complaints must prompt the physicians to obtain information about the patient's occupation and daily exposure to air pollution, which has been confirmed as a possible cause of anthracosilicosis . Lung auscultation may reveal wheezing, and along with symptoms of cough, dyspnea or breathlessness, is sufficient evidence to look for an underlying cause through lung function tests and imaging studies. In most cases, an obstructive pattern of impaired lung function is observed at spirometry   . On the other hand, plain radiography is a useful initial method for assessment, as non-homogeneous pulmonary infiltrates and reticulonodular opacities are typical for anthracosis and anthracosilicosis  , whereas calcified hilar nodes producing an "eggshell" pattern is typical for silicosis . High-resolution computed tomography (HRCT), however, is a superior imaging procedure compared to chest X-rays and is recommended whenever possible due to its ability to visualize the exact site of the nodules and identify the extent and nature of the opacities  . Finally, bronchoscopy may be implemented as a definite diagnostic measure, showing the abundance of anthracotic pigments and the presence of birefringent particles on polarized light microscopy, the main hallmarks of anthracosis and silicosis, respectively .