A) diagram showing the events leading up to formation of black spots. A1) particles enter the pleural space; A2) in focusing to exit via the stoma (St) some particles interstitialise through the loose lymphatic capillary endothelium and macrophages begin to accumulate in response; A3) macrophages and particles form a mature 'black spot' with mesenchymal cell activation and proliferation depending on the toxicity and dose of the particle. B) In B1 a single long fibre is intercepted as it attempts to negotiate the stomatal opening and is retained; 2) other fibres are caught up and there is an accumulation of retained long fibres; 3) macrophages attempt to phagocytose the fibres and undergo frustrated phagocytosis releasing a range of pro-inflammatory, genotoxic and mitogenic mediators close to the pleural mesothelial cells. PM = pleural mesothelium; St = stoma; LC = lymph capillary.
Donaldson et al. Particle and Fibre Toxicology 2010 7:5 doi:10.1186/1743-8977-7-5