Tuberc Respir Dis.  2014 Sep;77(3):124-131. 10.4046/trd.2014.77.3.124.

Clinical Relevance of Bronchial Anthracofibrosis in Patients with Chronic Obstructive Pulmonary Disease Exacerbation

• Kim H
• Cha SI
• Shin KM
• Lim JK
• Oh S
• Kim MJ
• Lee YD
• Kim M
• Lee J
• Kim CH

• KMID: 2320558
• DOI: http://doi.org/10.4046/trd.2014.77.3.124

Abstract

BACKGROUND
Bronchial anthracofibrosis (BAF), which is associated with exposure to biomass smoke in inefficiently ventilated indoor areas, can take the form of obstructive lung disease. Patients with BAF can mimic or present with an exacerbation of chronic obstructive pulmonary disease (COPD). The purpose of the current study was to investigate the prevalence of BAF in Korean patients with COPD exacerbation as well as to examine the clinical features of these patients in order to determine its clinical relevance.
METHODS
A total of 206 patients with COPD exacerbation were divided into BAF and non-BAF groups, according to computed tomography findings. We compared both clinical and radiologic variables between the two groups.
RESULTS
Patients with BAF (51 [25%]) were older, with a preponderance of nonsmoking women; moreover, they showed a more frequent association with exposure to wood smoke compared to those without BAF. However, no differences in the severity of illness and clinical course between the two groups were observed. Patients in the BAF group had less severe airflow obstruction, but more common and severe pulmonary hypertension signs than those in the non-BAF group.
CONCLUSION
Compared with non-BAF COPD, BAF may be associated with milder airflow limitation and more frequent signs of pulmonary hypertension with a more severe grade in patients presenting with COPD exacerbation.

Keyword

Anthracosis; Biomass; Pulmonary Disease, Chronic Obstructive; Tomography, Spiral Computed; Hypertension, Pulmonary

MeSH Terms

Anthracosis
Biomass
Female
Humans
Hypertension, Pulmonary
Lung Diseases, Obstructive
Prevalence
Pulmonary Disease, Chronic Obstructive*
Smoke
Tomography, Spiral Computed
Wood
Smoke

Figure

• 

  Figure 1 On the computed tomography scan, bronchial anthracofibrosis is characterized by smooth narrowing and thickening of multiple lobar or segmental bronchi (white arrowheads) and calcified lymph node enlargement adjacent to the narrowed bronchi (black arrows) with or without lobar or segmental atelectasis (white arrow).

• 

  Figure 2 The diameter of the main pulmonary artery (PA) and the diameter of the ascending aorta (AA) are measured at the level of the PA bifurcation.

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