Bronchial anthracofibrosis is defined as luminal bronchial narrowing associated with anthracotic pigmentation on bronchoscopy, without a relevant history of pneumoconiosis or smoking.
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Epidemiology
There is a preponderance for bronchial anthracofibrosis affecting women in their sixties.
Risk factors
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.
Clinical presentation
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.
Radiographic features
Plain radiograph
Chest x-ray findings are non-specific 2:
atelectasis (48%)
linear shadows (40%)
consolidation (29%)
mass lesion (7%)
CT
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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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