BRONCHIAL STENOSIS DUE TO ANTHRACOFIBROSIS

Study objectives: To define the clinical characteristics of the patien ts showing bronchoscopic findings of bronchial narrowing or obliterati on with black pigmentation on overlaying mucosa (we named this finding as ''anthracofibrosis''), and to determine the association of anthrac ofibrosis with tuberculosis. Patients and methods: The subjects of thi s study consisted of 28 patients; 8 men and 20 women, ranging in age f rom 42 to 86 years. The distinctive clinical features, natures of bron choscopic lesions, and radiologic findings were analyzed retrospective ly and summarized. Bacteriologic studies and results of pathologic exa mination were also assessed. Results: Chief complaints were cough (20/ 28) and dyspnea on exertion (17/28). The abnormal bronchoscopic findin gs were identified most frequently in the right middle lobe bronchus ( n=21/28) while more than one part of the bronchial tree was narrowed i n 22 patients. Abnormalities of bronchial airways on CT were associate d with peribronchial cuffs of soft tissue or surrounding lymph nodes. In 17 patients, active tuberculous infection was confirmed either bact eriologically (n=15) and/or histologically (n=8). Pathologic study of the lesion obtained by bronchoscopic biopsy or thoracotomy showed dens e bronchial and/or peribronchial fibrosis with interspersed black pigm ents. Conclusions: These findings strongly suggest that bronchial sten osis or obliteration with anthracotic pigmentation in the mucosa was c aused by as fibrotic response to active or old tuberculous infection. To prevent the spread of tuberculosis and avoid unnecessary invasive p rocedures, detailed examinations for the presence of active tuberculos is should be performed in patients with this unique bronchoscopic find ing.