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Bronchial Anthracofibrosis (Inflammatory Bronchial Stenosis with Anthracotic Pigmentation)

CT Findings

Hyae Young Kim1, Jung-Gi Im1, Jin Mo Goo1, Jae Yeol Kim2, Sung Koo Han2, Jae Kyo Lee1 and Jae Woo Song1

1 Department of Radiology and the Institute of Radiation Medicine MRC, Seoul National University, College of Medicine, #28, Yongon-dong, Chongno-gu, Seoul, 110-744, Korea.
2 Department of Internal Medicine, Seoul National University, College of Medicine, Seoul, 110-744, Korea.



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  		Fig. 1A. —68-year-old woman with bronchial anthracofibrosis who presented with cough and sputum. Sputum acid-fast stain was positive for acid-fast bacilli. Contrast-enhanced CT scan shows atelectasis of right upper lobe with smooth narrowing of right main bronchus and obstruction of right upper lobe bronchus. Note enlarged lymph node (arrow) adjacent to involved bronchus.

 


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  		Fig. 1B. —68-year-old woman with bronchial anthracofibrosis who presented with cough and sputum. Sputum acid-fast stain was positive for acid-fast bacilli. Bronchoscopic image shows right upper lobe bronchus is totally occluded, with black pigmentation in overlying mucosa (arrows). White dots are caused by reflection of light.

 


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  		Fig. 2A. —74-year-old woman with bronchial anthracofibrosis who presented with cough and sputum. Sputum acid-fast stain was negative for acid-fast bacilli. Contrast-enhanced CT scan at level of right upper lobe bronchus shows atelectasis and consolidation of right upper lobe. Bronchial wall is thickened and narrowed (arrowhead). Note enlarged lymph node (arrow) adjacent to right upper lobe bronchus.

 


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  		Fig. 2B. —74-year-old woman with bronchial anthracofibrosis who presented with cough and sputum. Sputum acid-fast stain was negative for acid-fast bacilli. Contrast-enhanced CT scan shows bronchial narrowing (arrowheads) in right middle lobe and lingular division of left upper lobe bronchus.

 


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  		Fig. 2C. —74-year-old woman with bronchial anthracofibrosis who presented with cough and sputum. Sputum acid-fast stain was negative for acid-fast bacilli. Bronchoscopic image shows opening of right middle lobe is nearly obstructed with black pigmentation (arrow).

 


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  		Fig. 3A. —66-year-old woman with bronchial anthracofibrosis who presented with cough and dyspnea but no evidence of tuberculosis. High-resolution CT scan at level of carina shows bronchial walls of right upper lobe and apicoposterior segment of left upper lobe are thickened and narrowed (arrowheads). Note calcified lymph nodes along right upper lobe bronchus (thick arrow) and adjacent to narrowed branch of apicoposterior segment of left upper lobe bronchus (thin arrow).

 


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  		Fig. 3B. —66-year-old woman with bronchial anthracofibrosis who presented with cough and dyspnea but no evidence of tuberculosis. High-resolution CT scan shows obstructed right middle lobe bronchus resulting in atelectasis of right middle lobe. Note calcified lymph nodes adjacent to expected opening site of right middle lobe bronchus (black arrows). Lingular segmental bronchus is also thickened with adjacent enlarged lymph nodes containing calcification (white arrow).

 


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  		Fig. 4. —69-year-old woman with bronchial anthracofibrosis who presented with cough. Sputum acid-fast stain was positive for acid-fast bacilli. Contrast-enhanced CT scan shows consolidation with fluid-bronchogram in right middle lobe. Note endobronchial lesion with low attenuation and multiple calcifications (black arrow). Note multiple nodules and patchy consolidations in superior segment of right lower lobe (white arrows), suggesting active tuberculous lesions.

 

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