Razi Journal of Medical Sciences

 Coal dust is associated with coal worker’s penumoconiosis, and about one-third of them progress to massive pulmonary fibrosis,that eventually makes multiple pulmonary nodules. Rarely,ischemia happens in these nodules and necrosis and perforation occurs in them spontaneously.In this case report, we introduce a person with pneumoconiosis and massive pulmonary fibrosis who was admitted in hospital because of severity in his symptoms.Three days after admission in spite of improvement in general condition, suddenly and spontaneously he experienced massive and black sputum which is named melanoptysis. In his chest x ray cavitary lesion was replaced to one of his modules.Other causes of cavitary lesion was ruled out and therefore the diagnosis of massive spontaneous melanoptysis was done.