Bronchial anthracofibrosis with interstitial lung disease: an association yet to be highlighted

Abstract

Bronchial anthracofibrosis (BAF), an emerging pulmonary disease due to long-standing exposure to biomass fuel smoke, is predominantly seen in females from developing nations. BAF is known to be associated with tuberculosis, pneumonia, chronic obstructive pulmonary disease and lung cancer, but the association of BAF with interstitial lung disease (ILD) is rare and yet to be highlighted. A 72-year-old woman with a 30-year history of exposure to biomass fuel smoke presented with dry cough and exertional dyspnoea. Imaging demonstrated interlobular, intralobular and peribronchovascular interstitial thickening and honeycombing adjoining the subpleural regions, suggestive of the usual interstitial pneumonia pattern. A restrictive pattern with diffusion defect was noted. Fibrebronchoscopy revealed a bluish-black anthracotic pigmentation with a narrowed and distorted left upper lobe, and apical segment of left lower lobe bronchus, confirming BAF. A diagnosis of BAF with ILD was made. To the best of our knowledge, this is the first detailed description of this association.

Occurrence of Bronchial Anthracofibrosis in Respiratory Symptomatics with Exposure to Biomass Fuel Smoke

“…Of the 58 patients with isolated BAF from Iran [17], peribronchial soft tissue thickening, bronchial narrowing or obstruction, segmental atelectasis, and lobar or multilobar collapse were the major findings. The CT findings in the two patients reported from India [7,14] included a MLS with air bronchogram and multifocal stenosis of RML bronchus in one [7], while the other had a UIP pattern with multifocal narrowing of left upper lobe bronchus [14]. In our study, multifocal bronchial stenosis and peribronchial cuffing were exclusively observed in patients with BAF.…”

“…Bronchial abnormalities in form of narrowing, multifocal bronchial stenosis, a feature indicative of BAF and peribronchial cuffing were observed. An unusual association of BAF with UIP was observed which was documented in detail [14]. In two studies from Korea www.journals.viamedica.pl [15,16] assessing CT features, bronchial narrowing/ /atelectasis was the most common finding.…”

The Co-occurrence of Bronchial Anthracofibrosis and Interstitial Lung Disease

“…Two patients had a UIP pattern, 5 while the third had an NSIP pattern. Both patients were elderly females, never smokers, with a significant history of biomass fuel smoke exposure.…”

“…Only two reports in four patients have been published, 3,4 with only one report detailing the co-occurrence of usual interstitial pneumonia (UIP) pattern with BAF. 5 The rarity of such a description in the literature prompted us to report 2 female patients who underwent diagnostic fiberbronchoscopy (FOB) for evaluation of BAF. A diagnosis of associated ILD was also established in these patients, 1 with non-specific interstitial pneumonia (NSIP) pattern and the other with UIP pattern.…”

Image Diagnosis: Bronchial Anthracofibrosis—A Bronchoscopic Diagnosis

“…3 Multifocal narrowing, when present on HRCT, is a characteristic imaging feature of BAF. 3,6 In developed countries, BAF is usually seen in immigrant populations in which elderly women patients would have had long-standing exposure to biomass fuel smoke. In a study from Canada, Hwang et al 7 documented the occurrence of BAF in ten patients from Asia.…”