Bronchial Anthracosis - Anthracofibrosis: Potential Causes and Clinical Characteristics

Objective: Anthracosis is characterized by accumulation of black pigment in the bronchial mucosa. It may cause anthracofibrosis by leading to mucosal destruction and deformity. In the present study, we aimed to investigate the underlying reasons and clinical characteristics of cases, in which anthracosis-anthracofibrosis was detected via bronchoscopy. Methods: The study comprised of 109 patients, in whom anthracosis –anthracofibrosis was detected by bronchoscopy between 2002 and 2012. Underlying reasons and clinical characteristics of the patients were analysed by reviewing medical records. The study was designed as a retrospective cohort study. Results: The present study included 52 males (47.7%) and 57 females (52.3%) with a mean age of 67.8±9.8 (34-85) years. Of the patients, 66 (60.6%) had exposure to biomass smoke, 38 (34.9%) had a history of smoking and 5 (4.5%) had occupational exposure. In bronchoscopy, 34 patients were shown to have anthracosis and 75 patients had anthracofibrosis. The right upper lobe (76 patients, 69.7%) and the left upper lobe (74 patients, 67.9%) were the most commonly involved sites; cough (58.7%) and dyspnoea (49.5%) were the most common symptoms, followed by chest pain (36.7%). The most common radiological findings were atelectasis (65.1%) and consolidation (55%). Of the patients, 46.8% had chronic obstructive pulmonary disease (COPD), 24.8% had pneumonia, 18.3% had tuberculosis and 10.1% had malignancy. Conclusion: Biomass smoke exposure is the most important risk factor for patients with anthracosis-anthracofibrosis. Such patients should be evaluated and followed-up for various pulmonary diseases including COPD, pneumonia, tuberculosis and malignancy.