Abstract
Introduction: Anthracofibrosis is a lesser known clinical entity. Patients present with chronic
symptoms of cough and breathlessness with a history of biofuel/wood fire smoke exposure.
There are distinct computed tomography (CT) imaging features of anthracofibrosis that
can differentiate it from more common conditions such as tuberculosis (TB) and bronchogenic
carcinoma. Findings include multifocal noncontiguous stenosis of bronchial tree, calcified
enlarged mediastinal or hilar nodes, and secondary lung parenchymal changes. However,
in TB, bronchostenosis usually involves a single lobar bronchus in a contiguous manner
with trachea and/or major bronchi also being affected. In this study, we highlight
the imaging characteristics of anthracofibrosis. Context: The CT findings of anthracofibrosis closely mimic TB and bronchogenic carcinoma,
hence we highlight the key imaging features of anthracofibrosis. Aims and Objectives: To identify and describe the CT imaging features of anthracofibrosis and correlate
it with bronchoscopic findings. Setting and Design: Retrospective study. Materials and Methods: Retrospectively, 40 patients were selected who were diagnosed with anthracofibrosis
on bronchoscopy and biopsy. However, CT scan records of only 14 patients were available
for review. Two radiologists reviewed the scans independently. Results: Most common CT finding was multisegmental noncontiguous bronchostenosis seen in 93%
patients mostly involving the right middle lobe. 85% of the cases showed lymph node
enlargement involving hilar, peribronchial, and mediastinal nodes. The nodes were
calcified in 91.7% of the cases, with 58% showing pressure effect on adjacent bronchi
due to nodal enlargement. The next common findings were peribronchial cuffing and
bronchial obstruction seen in 57 and 28% of the cases, respectively. Conclusion: The key imaging features of anthracofibrosis on CT are multifocal involvement of
bronchi with smooth peribronchial thickening and enlarged calcified lymph nodes.
Keywords
Anthracofibrosis - anthracosis - bronchostenosis - calcified lymph nodes
