Relationship between bronchial anthracofibrosis and endobronchial tuberculosis

Kim, Hyun Ji; Kim, Sang Dong; Shin, Dong Woo; Bae, Soo Hyun; Kim, Ah Lim; Kim, Ji Na; Jung, Seung Wook; Lee, Byung Ki; Kim, Yeon Jae

Abstract

BACKGROUND/AIMS
Various pulmonary diseases may be associated with bronchial anthracofibrosis (BAF). Our aim was to identify a relationship between BAF and endobronchial tuberculosis (EBTB).
METHODS
In total, 156 patients, diagnosed with EBTB using bronchoscopy, between June 1999 and May 2008, were included. Clinical and bronchoscopic findings between patients with BAF (n = 72, BAF group) and without BAF (n = 84, non-BAF) were analyzed retrospectively.
RESULTS
The crude odds ratio (OR) of BAF for EBTB was 8.88 (95% confidence interval, 6.37 to 12.37). On multivariate analysis, adjusting for age, history of biomass smoke exposure, and comorbidities, the most significant independent factor for EBTB was a history of biomass smoke exposure (adjusted OR, 17.471; adjusted p < 0.001). EBTB was more frequent in the right lung, particularly the right middle lobar bronchus, in the BAF group. Actively caseating, edematous-hyperemic, and ulcerative were the major types, with 77 (49%), 33 (21%), and 31 cases (20%), respectively. The BAF group had more ulcerative type, while the non-BAF group had more actively caseating type. The duration of EBTB treatment was similar between the groups. No significant difference was observed in the development of complications during treatment and posttreatment bronchostenosis between the groups.
CONCLUSIONS
These findings suggest that BAF may be a risk factor for EBTB and affect the location and morphological type at the time of EBTB development.