Presentation
Recurrent pneumonia. Testing and cultures for mycobacteria are repeatedly negative.
Patient Data
Left hilar bronchi show stenosis and difusse wall thickening with adjacent enlarged lymph nodes containing calcification. Smooth luminal narrowing at segmental bronchi of right upper lobe.
Stenosis of the bronchus to the middle right lobe and upper and lower left lobes. Anthracofibrosis stain in bronchial bifurcation between upper and lower left lobes.
Case Discussion
Bronchial anthracofibrosis is a bronchoscopic finding showing dark anthracotic pigmentation, due to deposition of carbon particles along with iron, lead, cadmium and other inorganic or organic material which can cause pigmentation on the bronchial mucosa in conjunction with bronchial narrowing or obliteration.
Patients usually are elderly women who present with non-specific respiratory symptoms. The clinical significance of bronchial anthracofibrosis and its strong association with certain diseases such as TB, pneumonia, chronic obstructive pulmonary disease (COPD), bronchial asthma and lung cancer is increasingly being recognized.
That’s why we should think about this entity when we are in front of certains CT findings such as bronchial narrowing accompanied by thickening of the wall or peribronchial cuffing with segmental collapse distal to the involved bronchi.
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