Bronchial anthracofibrosis: The spectrum of radiological appearances

Abstract

Bronchial anthracofibrosis (BAF), caused by long-standing exposure to biomass fuel smoke, has emerged as a distinct pulmonary disease. It is usually seen in elderly females who have worked long hours in poorly ventilated kitchen full of smoke due to incomplete combustion of biomass fuel. The diagnosis is confirmed on bronchoscopic visualization of bluish-black anthracotic pigmentation along with narrowing/distortion of the affected bronchus. BAF has been associated with clinical conditions such as pulmonary tuberculosis, chronic obstructive pulmonary disease, pneumonia, and malignancy. Tuberculosis, once thought to be the causative agent for BAF, is now considered to be an association. BAF has a diverse radiological presentation and the presence of associated clinical conditions often confound the radiological picture. The imaging features of BAF include primary imaging characteristics, which pertains to the disease entity directly, and secondary features based on the presence of associated conditions. High-resolution computed tomography findings of multifocal bronchial narrowing and peribronchial cuffing are considered to be specific diagnostic features of BAF. In addition, the diagnostic probability is increased in the presence of mediastinal adenopathy and collapse/atelectasis with middle lobe syndrome being the most common presentation. This pictorial essay highlights the range of imaging appearances in patients with BAF.

Peribronchial Connective Tissue Infection Caused by<i> Bifidobacterium longum</i> and <i>Veillonella</i> Species Mimicking Lung Cancer

“…The minor fissure is concave peripherally but convex centrally, causing the shape of the fissure to resembles an S, hence the name. This sign is highly suggestive of a neoplasm, such as primary lung cancer, but other malignant conditions, such as metastatic lung cancer, malignant lymphoma, mediastinal tumor, or enlarged lymph nodes, may also produce this sign (1)(2)(3)(4).…”

“…Atelectasis of the right upper lobe of the lung with mass shadow in the right hilum on chest radiograph is known as the Golden S sign (inverted S sign), and typically associated with right upper lobe atelectasis due to lung cancer (1)(2)(3)(4).…”

A case of pulmonary anthracofibrosis presented as multiple lung nodules

“…According to one report [ 8 ], non-carbonaceous lung pollutants were silicon and aluminum, and another study [ 9 ] reported the deposition of silica, aluminum and iron. Taken together, the simultaneous exposure of carbon smoke from fuel combustion and inorganic compounds, including limestone and alumina-silicates, seems to be the most likely cause of anthracosis [ 1 , 3 , 10 ].…”

“…It appears mainly as ‘bronchial anthracofibrosis’ (BAF), which is characterized by anthracotic pigmentation and narrowing of the associated bronchi [ 2 ]. Hence, bronchial stenosis, endobronchial anthracotic pigmentation, and mediastinal lymphadenopathy accompany cases of BAF [ [1] , [2] , [3] , [4] , [5] ]. In few instances, a lung mass has also been reported along with anthracotic pigmentation of the bronchial mucosa [ 4 ].…”

“…In few instances, a lung mass has also been reported along with anthracotic pigmentation of the bronchial mucosa [ 4 ]. BAF may also be accompanied by lung carcinoma [ 3 , 5 ].…”