Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Bronchial Anthracofibrosis (Inflammatory Bronchial Stenosis with Anthracotic Pigmentation)
- Radiologic Findings
- Chest radiograph shows segmental air-space consolidation and atelectasis in the right upper lobe.Contrast-enhanced CT scans show luminal narrowing and bronchial wall thickening of right upper and left lower lobar bronchus with peribronchial calcified lymph nodes.
Fiberoptic bronchoscopy shows irregularity and dark pigmentation in the bronchial mucosa associated with mild narrowing of bronchial lumen. (A-view from left upper lobar bronchus; B-view from narrowed right upper lobar bronchus).
- Brief Review
- Anthracofibrosis is a bronchoscopic finding showing dark anthracotic pigmentation on the bronchial mucosa in conjunction with bronchial narrowing or obliteration (1). Characteristic features of the patients with anthracofibrosis in one study were as follows (1): (a) preponderance of older female patients; (b) no association with pneumoconiosis or smoking; (c) chief complaints of cough and dyspnea without constitutional symptoms; (d) segmental or lobar consolidation on simple chest radiographs; (e) abnormalities of bronchial airways with peribronchial cuffs of soft tissue or surrounding lymph nodes on chest CT; (f) most frequent involvement of the right middle lobe bronchus, and (g) active tuberculous infection demonstrated in >60% of the patients. Recent investigators propose that bronchial tuberculosis is one of the most likely causes for the development of bronchial anthracofibrosis. The hypothesis about the development of bronchial anthracofibrosis is as follows. Perforation of a tuberculous lymph node into the adjacent bronchi and carbon particles in the lymph nodes may penetrate through the bronchial wall as deep as the mucosa, resulting in coloring of the bronchial mucosa. Subsequently, healing with fibrotic response may occur in the bronchi, resulting in bronchial narrowing or obstruction with anthracitic pigmentation (1).
- References
- 1. Chung MP, Lee KS, Han J, Kim H, Rhee CH, Han YC, Kwon OJ. Bronchial stenosis due to anthracofibrosis. Chest. 1998; 113:344-350.
- Keywords
- Airway, Non-infectious inflammation, Bronchial Anthracofibrosis (Inflammatory Bronchial Stenosis with Anthracotic Pigmentation)