Bronchial anthracofibrosis

Last revised by Yuranga Weerakkody on 28 Jun 2020

Bronchial anthracofibrosis is defined as luminal bronchial narrowing associated with anthracotic pigmentation on bronchoscopy, without a relevant history of pneumoconiosis or smoking.

There is a preponderance for bronchial anthracofibrosis affecting women in their sixties.

Exposure to biomass fuel smoke 2,4 is a risk factor. There is also a potential relationship between bronchial anthracofibrosis and tuberculosis 1. Co-existence of tuberculosis and anthracofibrosis is high (~50%), and the CT findings are similar for the two conditions 3,4.

Chronic productive cough, dyspnea, hemoptysis, chest pain, fever and general weakness 1,2.

Pulmonary functional tests show an obstructive pattern in 50% of the patients affected, with small airway dysfunction varying according to the severity of bronchial stenosis.

Chest x-ray findings are non-specific 2:

  • segmental collapse distal to the involved bronchi 1,2
    • right middle lobe is the most frequently involved 1
  • enlarged mediastinal or hilar lymph nodes adjacent to the involved bronchi or calcified nodes adjacent to the bronchi 1,2
  • bronchial narrowing accompanied by thickening of the wall or peribronchial cuffing 1,2
  • other findings: fibrotic bands, nodules, bronchiectasis

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