Hut Lung: A Domestically Acquired Particulate Lung Disease

Abstract

We report an illustrative case of advanced "hut lung," or domestically acquired particulate lung disease (DAPLD), in a recently emigrated nonsmoking Bangladeshi woman with a history of 171 hour-years of exposure to biomass smoke. She presented with symptoms of chronic cough, dyspnea, and early parenchymal lung disease. High-resolution computed tomography (CT) of the chest demonstrated numerous 2- to 3-mm nodules, sparing the pleural surface. To our knowledge, this is the first such report of CT findings in the literature. Bronchoscopy yielded typical anthracotic plaques and diffuse anthracosis with interstitial inflammation on histopathologic examination of biopsy specimens. DAPLD is potentially the largest environmentally attributable disorder in the world, with an estimated 3 billion people at risk. Caused by the inhalation of particles liberated from the combustion of biomass fuel, DAPLD results in significant morbidity from infancy to adulthood. Clinically, DAPLD manifests a broad range of disorders from chronic bronchitis and dyspnea to advanced interstitial lung disease and malignancy. While a detailed environmental history is essential for making the diagnosis in most individuals, for patients with advanced DAPLD, invasive modalities such as bronchoscopy with transbronchial biopsy and examination of bronchoalveolar lavage fluid help differentiate it from other diseases. Recognition of this syndrome and removal of the patient from the environment is the only treatment. The development of well-controlled interventional trials and the commitment of sufficient resources to educate local populaces and develop alternative fuel sources, stove designs, and ventilation are essential toward reducing the magnitude of DAPLD.

Anthracosis and Large Mediastinal Mass in a Patient with Healed Pulmonary Tuberculosis

“…[1][2][3][4][5][6] The terms "hut lung" or "domestically acquired particulate lung disease" have been used to describe the condition. 7 A diagnostic feature in anthracosis is the black-colored deposits along the airway or lymph nodes. Problems caused by chronic exposure to biomass smoke and other particulates, such as dust or silicates from food grinding, are becoming more relevant in the western world due to immigration.…”

The Demographic, Clinical, Radiographic and Bronchoscopic Evaluation of Anthracosis and Anthracofibrosis Cases

“…Air pollution, biomass smoke and cigarette smoke are also known as the other enviromental factors for anthracosis [1][2][3][4][5]. The term "anthracotic" is usually used to describe coal and other black pigments of which carbon is a major constituent.…”

CT differentiation of enlarged mediastinal lymph node due to anthracosis from metastatic lymphadenopathy: a comparative study proven by endobronchial US-guided transbronchial needle aspiration

“…Anthracosis is a form of pneumoconiosis which is not only caused by coal dust, but also by other environmental factors such as air pollution, biomass fuels used extensively for cooking ("hut lung"), and cigarette smoking (13)(14)(15)(16)(17)(18). It has been recently demonstrated that the presence of microscopic anthracotic pigment in EBUS-TBNA of enlarged lymph nodes is negatively associated with lymph node malignancy (19).…”