The clinical investigation for determining the etiology of bronchial anthracofibrosis

No, Tae Mook; Kim, In Seek; Kim, Seon Woong; Park, Dong Hi; Joeng, Jae Kwon; Ju, Dong Wook; Chyun, Jae Hyun; Kim, Yeon Jae; Shin, Hyun Woong; Lee, Byung Ki

Abstract

BACKGROUND: The bronchial anthracofibrosis has been thought to be a unique clinical syndrome caused by a fibrotic response to active or old tuberculous infection, but recent studies suggest that long-term exposure to woodsmoke may be the cause of the development of bronchial anthracofibrosis and the tuberculosis is thought to be a disease frequently associated with bronchial anthrocofibrosis, not the main etiology. The purpose of this study was to elucidate the relationship between the bronchial anthracofibrosis and the long-term exposure to woodsmoke and tuberculosis through analyses of the clinical features of patients with bronchial anthracofibrosis.
METHODS
166 patients having bronchial anthracofibrosis confirmed by bronchoscopy were included in this study. They were 23 males and 143 females, having mean sge 72.4 years, ranging from 56 to 91. The epidemiologic features, distinctive clinical features, physiologic findings, radiologic findings and bronchoscopic findings were analyzed retrospectively.
RESULTS
All the patients living in rural area (129 of 166) had experienced long-term exposure to woodsmoke. The history of tuberculosis was obtained in 52 patients without history of occupational exposure to dust. The predominant chest CT findings were atelectasis, bronchial stenosis and calcified or noncalcified lymph node enlargements. The most common abnormality of pulmonary function was obstructive pattern, observed in 47.8%. The bronchoscopic examination disclosed multifocal anthracotic plaques mostly at the bifurcation of lobar or segmental bronchi, particularly in upper lobe. The bronchial stenosis was frequently observed in right middle and upper lobe. The associated diseases were obstructive airway disease in 56, obstructive pneumonia in 40, active tuberculosis in 36, and lung cancer in 11 patients.
CONCLUSION
The bronchial anthracofibrosis, in the patient who has long-term experience to woodsmoke inhalation without any history of environmental exposure to dust, is one of the manifestation of lung disease related to woodsmoke inhalation, and is frequently associated with various pulmonary diseases, including tuberculosis.