Pneumoconiosis, very popular to coal miners who are exposed to coal dusts dominantly, was introduced in the 19th century to describe lung diseases consequent to the inhalation of mineral dusts. Coal workers' pneumoconiosis(CWP) colloquially called "black lung" in the United States, is a distinct pathologic entity resulting from the tissue reaction to deposits of dust include the coal macule, which associated with focal emphysema constitutes the characteristic lesion of simple CWP and complicated CWP or progressive massive fibrosis(PMF). Coal mining are also associated with chronic bronchitis, chronic airflow limitation, and/or generalized emphysema. Progressive massive fibrosis lesions may imprint on and obliterate airways and vessels, and cavitation is not uncommon, being the consequence of ischemic necrosis or mycobacterial infections. We report a case which is unusual form of progressive massive fibrosis to be differentiated from lung carcinoma. It is a rapid growing PMF with ischemic necrosis. By the studies which are about risk of having progressive massive fibrosis, it is predicted to be 1.4%. And the other study shows that simple pneumoconiosis clearly predisposed to PMF, with five year attack rates of 13.9%, 12.5%, 4.4% and 0.2% among men with categories 3, 2, 1, and 0 respectively at the start of the risk periods.