Tuberc Respir Dis.  2010 Feb;68(2):67-73. 10.4046/trd.2010.68.2.67.

The Clinical Significance of Bronchial Anthracofibrosis Associated with Coal Workers' Pneumoconiosis

• Kim MH
• Lee HY
• Nam KH
• Lim JM
• Jung BH
• Ryu DS

• KMID: 2050587
• DOI: http://doi.org/10.4046/trd.2010.68.2.67

Abstract

BACKGROUND
In previous study, most patients with bronchial anthracofibrosis (BAF) were non-miners, and non-occupational old aged females. However, the clinical significance of BAF in patients with coal workers' pneumoconiosis (CWP) is unknown.
METHODS
Among patients with CWP who transferred to our hospital for an evaluation of associated pulmonary diseases, 32 patients who had undergone a bronchofibroscopy (BFS) and chest computed tomography (CT) examination were evaluated for the association of the BAF using a retrospective chart review.
RESULTS
Nine of the 32 CWP patients (28%) were complicated with BAF. Four of the 16 simple CWP patients (25%) were complicated with BAF. According to the International Labor Organization (ILO) classification by profusion, 2 out of 3 patients in category 1, 1 out of 8 patients in category 2 and 1 out of 3 patients in category 3 were complicated with BAF. Five out of 16 complicated CWP patients were complicated with BAF. Three out of 7 patients in type A and 2 out of 5 patients in type C were complicated with BAF. CWP patients with BAF had significantly greater multiple bronchial thickening and multiple mediastinal or hilar lymph node enlargement than the CWP patients without BAF. There was no difference in the other clinical features between the CWP patients with BAF and those without BAF.
CONCLUSION
Many CWP patients were complicated with BAF. The occurrence of BAF was not associated with the severity of CWP progression. Therefore, a careful evaluation of the airway with a bronchoscopy examination and chest CT is warranted for BAF complicated CWP patients who present with respiratory symptoms and signs, even ILO class category 1 simple CWP patients.

Keyword

Pneumoconiosis; Bronchoscopy; Bronchial Anthracofibrosis

MeSH Terms

Aged
Bronchoscopy
Coal
Female
Humans
Lung Diseases
Lymph Nodes
Pneumoconiosis
Retrospective Studies
Thorax
Coal

Figure

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  Figure 1 70-year-old man with coal workers' pneumoconiosis associated with bronchial anthracofibrosis. (A) Contrast enhanced CT shows bronchial wall thickening due to enlarged lymph node and peribronchial fibrosis. (B) Lung setting on CT shows multiple p type nodules in the both upper lobes. (C) Flexible bronchoscopy shows bronchial narrowing with engorged mucosal vessel and anthracotic pigmentation in the right upper lobe bronchus. (D) Anthracotic pigmentation and bronchial stenosis is also noted in the right middle lobe bronchus.

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