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

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.

General anesthesia in a patient with known bronchial anthracofibrosis: A case report / 대한마취과학회지

Bronchial anthracosis was recently defined in the English radiology literature as a luminal narrowing associated with anthracotic pigmentation on bronchoscopy without a relevant history of pneumoconiosis or smoking. Anthracosis refers to the presence of carbon particles in the lungs, not to a disorder per se. Anthracofibrotic lesions carry the potential risk of massive hemorrhage during endobronchial procedures. This report describes a case of general anesthesia for a left modified radical mastectomy due to an intraductal carcinoma in a patient with known bronchial anthracofibrosis.

Ventilatory Dynamics according to Bronchial Stenosis in Bronchial Anthracofibrosis / 결핵및호흡기질환

BACKGROUND: Bronchial anthracofibrosis usually manifest as a form of obstructive airway disease, and can be accompanied by parenchymal diseases such as pneumonia, and pulmonary tuberculosis. This study investigated the ventilatory dynamics according to the severity of bronchial stenosis in patients with bronchial anthracofibrosis. Method : One hundred and thirteen patients with bronchial anthracofibrosis that was confirmed by bronchoscopy and who had undergone a pulmonary function test were enrolled in this study group. The correlation coefficients between the pulmonary functional parameters and the number of lobes with bronchial stenosis were investigated. RESULTS: The incidence of ventilatory dysfunction was 56(49.6%) for obstructive, 8(7.1%) for restrictive, 2(1.8%) for mixed, and 47(41.6%) for a normal pattern. The FEV1/FVC, FEF25~75%, FEF25%, FEF50%, FEF75%, and PEF showed a significant negative correlation (p<0.05) and the Raw had a significant positive correlation with the number of lobes with bronchial stenosis(p<0.001). CONCLUSION: These findings suggest that the most common abnormality of the ventilatory function in bronchial anthracofibrosis is an obstructive pattern with a small airway dysfunction according to the severity of bronchial stenosis.

The Clinical Significances of Bronchial Anthracofibrosis in the Patients with Endobronchial Tuberculosis / 결핵

BACKGROUND: Bronchial anthracofibrosis is one of the main manifestations of lung disease that is related to woodsmoke inhalation, and it is frequently associated with various pulmonary diseases, such as tuberculosis. The purpose of this study was to evaluate the clinical significance of bronchial anthracofibrosis in patients with endobronchial tuberculosis. METHODS: 63 patients, who were diagnosed with endobronchial tuberculosis using bronchoscopy, were included in this study. The patients consisted of 12 males and 51 females, having mean age of 59.5 years. The clinical features, radiologic and bronchoscopic findings between the patients with (37) and without (26) bronchial anthracofibrosis were analyzed retrospectively. RESULTS: When the patients were older, bronchial anthracofibrosis was more frequent. The endobronchial tuberculosis, which was located at the right middle lobal bronchus, was more frequent in the patients with bronchial anthracofibrosis than in the patients without bronchial anthracofibrosis. In the morphologic types of endobronchial tuberculosis, patients with bronchial anthracofibrosis had more edematous-hyperemic and ulcerative types, while patients without bronchial anthracofibrosis had more active caseating. CONCLUSION: These findings suggest that the presence of bronchial anthracofibrosis can possibly influence the locations and morphologic types of endobronchial tuberculosis.

Clinical Features of Simple Bronchial Anthracofibrosis which is not Associated with Tuberculosis / 결핵

BACKGROUND: Bronchial anthracofibrosis (BAF) is a dark black or brown pigmentation of multiple large bronchi associated with a fibrotic stenosis or obliteration that is incidentally found during a diagnostic bronchoscopy. Some reporters have suggested endobronchial tuberculosis or tuberculous lymphadenitis as a possible cause of BAF. However, some BAF patients do not have any medical history of tuberculosis. The aim of this study was to elucidate the clinical features of simple BAF patients, which were not associated with tuberculosis. METHODS: We reviewed the patients' charts retrospectively and interviewed all BAF patients who were followed up for 1 year or more. Among the 114 BAF patients, 43 patents (38 %) had no associated tuberculosis, cancer and pneumoconiosis. The clinical characteristics, radiological findings and associated pulmonary diseases of these patients were evaluated. RESULTS: Most patients were non-smokers, old aged, housewifes who resided in a farming village. The common respiratory symptoms were dyspnea, cough and hemoptysis. The predominant X-ray findings were a multiple bronchial wall thickening(89%), bronchial narrowing or atelectasis (76%) and a mediastinal lymph node enlargement with/without calcification (78%). Pulmonary function test usually showed mild obstructive ventilatory abnormalities but no patient showed a restrictive ventilatory pattern and the patients were frequently affected with chronic bronchitis(51%), post-obstructive pneumonia(40%) and chronic asthma(4%). CONCLUSION: Because BAF is frequently associated with chronic bronchitis and obstructive pneumonia as well as tuberculosis, a careful clinical evaluation and accurate differential diagnosis is more essential than empirical anti-tuberculous medication.