The CT Findings of Bronchial Anthracofibrosis: Comparison of Cases with or without Active Tuberculosis

ABSTRACT

PURPOSE: To assess the CT findings of bronchial anthracofibrosis with or without active tuberculosis. MATERIALS AND METHODS: Analysis of the CT scans of 35 patients with bronchoscopically proven anthracofibrosis revealed that 25 were negative for active tuberculosis and ten were positive. Bronchial and pleural lesions, pulmonary parenchymal lesions, and mediastinal/hilar lymph nodes were retrospectively evaluated. RESULTS: Common radiologic findings of anthracofibrosis included diffuse bronchial narrowing (50%), wall thickening (37%), and mass-like soft tissue density in central bronchi (8%). The right middle lobe was most commonly involved (31%). Common findings of pulmonary parenchymal lesions included consolidation (37%), atelectasis (31%), and ground-glass opacity (10%). These bronchial or pulmonary parenchymal findings were common in patients with or without active tuberculosis. Findings of multiple poorly defined small nodules, including branching opacities and consolidation with internal low density were seen only in patients with active tuberculosis (p<0.01), while enlarged mediastinal or hilar lymph nodes were frequently observed in patients with or without active tuberculosis. Necrotic lymph nodes were present only in those with active tuberculosis (p<0.05). CONCLUSION: When CT scans depict central bronchial narrowing, wall thickening, or mass-like soft tissue density with atelectasis or consolidation, especially in older patients without a distinct central lung mass lesion, anthacofibrosis should be included in the differeatial diagnosis. When multiple poorly defined small nodules, including branching opacities, consolidation with internal low density or necrotic lymph nodes are observed, the possibility of concomitant active tuberculosis should be considered.