Bronchial Anthracosis Research Articles

Study the frequency of bronchial anthracosis and its influencing factors in patients undergoing bronchoscopy in Ardabil city hospital, 2013-2015

Background: Bronchial anthracosis is defined as appearance of multiple dark anthracotic pigmentations on large airway mucosa with or without airway narrowing or obliteration. This study aims to investigate the frequency of bronchial anthracosis and its influencing factors in patients undergoing bronchoscopy.Methods: In this cross-sectional study, data was obtained from reviewing the files of 900 patients who underwent bronchoscopy in Ardabil city Hospital. Those with dark pigmentation on their airways mucosa were considered as having bronchial anthracosis. During bronchoscopy, samples were collected from the airways in the form of bronchoalveolar lavage and then the smear and culture of these samples were examined for acid fast bacilli. Type of fuel used for cooking in the kitchen and for heating in their house, history of smoking, the patient’s geographical location and occupation were recorded by a checklist and then evaluated.Results: Of 900 cases, 42 (4.6%) had bronchial anthracosis, out of which 23 (55%) were male and most were in urban areas. Majority of patients were in the age range of 60 to 70 years. Of 11 farmers with anthracosis, 7(6.63%) patients used fossil fuels for heating. Among the anthracosis patients, 11 (21.2%) subjects had Tuberculosis. There was a significant difference between age, habitant of patients, pulmonary tuberculosis and bronchial anthracosis.Conclusions: There was a significant correlation between age of patients, pulmonary tuberculosis and bronchial anthracosis, therefore, performing necessary tests and follow-ups for pulmonary tuberculosis is necessary in cases that undergo bronchoscopy for any reason and those with bronchial anthracosis.

Assessment of diagnostic value of different methods (culture, PCR and biopsy) for the diagnosis of tuberculosis in patients with bronchial anthracosis

Introduction: Although several studies have shown the relationship between tuberculosis (TB) and anthracosis, few studies have investigated the diagnostic value of various methods of diagnosis of TB in these patients. Objectives: This study was conducted to investigate the diagnostic value of different methods including smear, culture and polymerase chain reaction (PCR) of bronchoalveolar lavage (BAL) sample and bronchial biopsy specimens in the diagnosis of TB in patients with bronchial anthracosis. Patients and Methods: This descriptive cross-sectional study was performed on 67 patients referring for bronchoscopy, and bronchial anthracosis was an incidental finding. The BAL sample and patients’ bronchial biopsies were examined for TB infection. Results: The most affected areas by anthracosis were the right and the left upper lobes. The BAL smear and its culture were positive in 12 (20%) and 10 patients (17%), respectively. The PCR of BAL sample was positive in 37%. Non-specific chronic inflammation followed by bronchial anthracosis was the most common pathologic findings. According to pathological examinations, nine patients (13%) had TB. Sensitivity and specificity of the PCR versus culture were 90% and 70%, respectively, with a diagnostic accuracy of 74%. Sensitivity, specificity and diagnostic accuracy of the pathologic examination of biopsy specimen were 33%, 85% and 74%, respectively. Conclusion: Findings of this study showed that nearly one fifth of patients with bronchial anthracosis suffer from TB simultaneously. In these patients, PCR of the BAL and pathologic examination of the biopsy specimen had the same diagnostic accuracy, but the sensitivity of PCR was three times higher. However, application of PCR and pathologic examination does not seem to have more diagnostic advantages than BAL culture for the diagnosis of TB, although the results by PCR may help to diagnose the disease sooner.

Occurrence of bronchial anthracofibrosis in respiratory symptomatics with exposure to biomass fuel smoke.

Bronchial anthracofibrosis (BAF), confirmed bronchoscopically, is characterised by bluish-black mucosal pigmentation and distortion/narrowing of the bronchus. We investigated the occurrence of BAF in respiratory symptomatics with biomass fuel smoke exposure and evaluated its clinico-radiological attributes and impact on functional status. Of the eighty subjects evaluated, 60 consented for fiberoptic bronchoscopy (FOB). All 60 subjects also underwent chest radiography, high resolution computed tomography (HRCT) of the thorax, complete pulmonary function testing including diffusion capacity and six-minute-walk test. Information regarding cardinal respiratory symptoms and duration of biomass fuel smoke exposure was documented. FOB evaluation revealed that 24 patients had BAF (Group 1), 17 had bronchial anthracosis (Group 2) and 19 had normal appearance (Group 3). Group 1 patients had significantly higher biomass fuel smoke exposure (p < 0.0001), lower mean post bronchodilator FEV₁/FVC values (P = 0.02) and lower walk distance (p = 0.003) with greater desaturation. On HRCT, segmental collapse and consolidation were significantly higher in Group 1 while fibrotic lesions were the predominantly seen in Groups 2 and 3. A significant inverse correlation in Group 1 was seen between exposure index, six-minute-walk distance and spirometric parameters. In Group 1, the right middle lobe (RML) bronchus was most commonly involved (15/24 [62.5%]). In Group 2, RML and left upper lobe bronchi were affected in 8/17 (47.1%) patients each. All patients in our study were females. Those with BAF had poorer lung functions and functional status as compared to those with anthracosis only. On imaging, multifocal bronchial narrowing was specific to BAF. .

Comparison of samples obtained from bronchoscopy of patients with and without bronchial anthracosis for investigating the prevalence of Mycobacterium tuberculosis.

Bronchial anthracosis is caused by the deposition of carbon, silica or asbestos particles in mucosal and submucosal cells and macrophages, and it can lead to chronic bronchial obstruction. Certain studies have reported an association between bronchial anthracosis and infection with Mycobacterium tuberculosis. This study aimed to compare the samples obtained from bronchoscopy of patients with and without bronchial anthracosis for investigating the prevalence of Mycobacterium tuberculosis. This was a cross-sectional study conducted between 2010 and 2013. A total of 514 patients underwent diagnostic bronchoscopy for pulmonary diseases. A sample of bronchoalveolar lavage fluid was taken from each patient and tested for Mycobacterium tuberculosis through smear and culture techniques. The data were analyzed with Chi-square and Fisher's exact test, with p ≤.05 set as the significant level. Totally, 514 patients were evaluated through bronchoscopy; bronchial anthracosis was diagnosed in 207 cases, of which 129 (62.3%) were women. The rate of pulmonary tuberculosis was significantly higher (p = .002) in the bronchial anthracosis group. In our study, the prevalence of pulmonary tuberculosis was significantly higher in the bronchial anthracosis group. Given that pulmonary tuberculosis is still one of the health problems of the present century, increased attention to specific risk factors including bronchial anthracosis in patients having pulmonary symptoms is recommended.

Frequency of tuberculosis in anthracosis of the lung: a systematic review.

Anthracosis of the lung is the blackening of bronchial tissues which can lead to chronic bronchial obstruction. Many studies have shown association of bronchial anthracosis and tuberculosis. The aim of this study was accumulation of scattered studies and getting the definite conclusion about the association between anthracosis and tuberculosis. We conducted a systematic search that included studies with sufficient information about the frequency of tuberculosis in anthracosis (anthracofibrosis) patients and non-anthracotic control group. Moreover, tuberculosis should be confirmed by microbiologic (smear or culture) or histopathological methods. Twelve studies (eight studies on anthracofibrosis and four studies on anthracosis as a general term) comprising of 6280 patients was entered into our meta-analysis. The frequency of tuberculosis in all anthracosis patients was 22.5 % (32.3 % for anthracofibrosis and 16.6 % for anthracosis), which was significantly higher than the control group. Determination of risk showed that the cumulated odds ratio of tuberculosis in all studies of anthracosis was 3.16 (95 % CI = 2.49 - 6.85), which revealed significantly higher risk than the control group. The analysis of the subgroups showed that the cumulated odds ratio of tuberculosis in subgroups of anthracofibrosis (3.28; 95 % CI = 2.16 - 9.12) was significantly higher than anthracosis as a general term (2.85; 95 % CI = 1.73 - 6.61). The association of tuberculosis with all types of anthracosis of the lung was confirmed and a proper mechanism should be defined.

Prevalence of tuberculosis in patients with anthracosis: study on 150 subjects.

A probable concordance and association between pulmonary tuberculosis and anthracosis was observed in the published literature. We conducted this study to evaluate the clinical and radiologic characteristics of patients with bronchoscopic evidence of anthracosis as well as the prevalence of pulmonary tuberculosis in patients with anthracosis. Included in the study were 150 consecutive patients with evidence of anthracosis as evidenced by bronchoscopy. Pulmonary tuberculosis diagnostic work up which included bronchoalveolar lavage, sputum smears and cultures, or histologic examination of lung biopsies was performed on all patients. Patients' clinical, pathological, and radiological findings were also recorded and analyzed. A total of 88 men and 62 women, ranging in age from 42 to 92 years were included in the study. Dyspnea (38.7%) and productive cough (35.3%) were among the most common chief complaints. The abnormal bronchoscopic findings were seen most frequently in the right middle lobe bronchus. In 42 patients pulmonary tuberculosis was confirmed either bacteriologically (n = 32) or histologically (n = 10). CT scans of 26 patients were examined, of which the most frequent findings were consolidation and a reticular pattern. Pleural involvement was observed in 14 patients. Prevalence of pulmonary tuberculosis was higher among those with bronchial stenosis (P < 0.05). These findings have suggested that bronchial anthracosis, especially cases of localized anthracosis, in patients with bronchial stenosis and in those without a history of smoking or occupational exposure may be caused by tuberculosis.

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

Background: The aim of the study was to evaluate the demographic features, clinical findings, radiological and bronchoscopical findings of patients with bronchial anthracosis. Methods: Among 1541 patients who underwent broncoscopy in our bronchoscopy unit between 2006-2008, 104 patients with anthrocosis were included in this prospective study. The patient’s geographical location, occupation, type of fuel used for cooking in the kitchen and for heating in their house, admission complaints, chest x-ray and thorax computed tomography (CT) findings, bronchoscopic images and the accompanying pathological diagnosis were recorded and evaluated. Results: A total of 104 (6.7%) patients with a mean age of 61.35±13.34 years were included in this study; 49 (47.1%) of which were female, 55 (52.9%) male.The most common complaints were cough, dyspnea and sputum production in 71.2%, 57.7% and 49.0% patients, respectively. In 48 (46.1%) patients history of cigarette smoking was found. While in 31 (38.3%) patients exposure to mineral dust or biomass in their job was observed, 37 (45.7%) patients were housewives. In all of the patients biomass exposure was found because of the fuel used for heating or in kitchens. Regarding geographical location, we found that the majority of the patients (38.5%) were from Black Sea region located in northern Anatolia. While the most common chest x-ray findings were consolidation (51.9%) and fibrosis (18.3%), consolidation (38.5%) and fibrosis (36.5%) were also found to be the leading thorax CT findings. The most common bronchoscopic findings were bilateral anthracosis, stenosis and bronchial torsion 67.3%, 40.4% and 23.1% patients, respectively. Among the anthracosis patients, with bronchoscopy 11 of them were found to have malignancy and 7 of them tuberculosis. Conclusion: Large scale, country-wide studies should be conducted for the determination of epidemiological data of bronchial anthracosis and anthracofibrosis in our country in which a high rate of biomass exposure is found.

Bronchial Anthracosis: A Potent Clue for Diagnosis of Pulmonary Tuberculosis

Occupational exposure to carbon, silica, and quartz particles are predisposing factors for bronchial anthracosis. In some cases anthracosis may be associated with mycobacterium tuberculosis. This study aims to investigate the clinical, radiographic, and bacteriologic findings in bronchial anthracosis patients and its association with tuberculosis. This is a prospective study conducted between 1998 and 2001. A total of 919 patients underwent diagnostic bronchoscopy for pulmonary diseases. Of these, 71 patients showed evidence of bronchial anthracosis, 32 (45.8%) males and 39 (54.2%) females, age range, 30-92 years. The distinctive clinical features, nature of bronchoscopic lesions, and radiologic findings were analyzed prospectively and summarized. Bacteriologic studies and results of laboratory examinations were also assessed. Forty-one (57.8%) patients had positive smears or cultures for mycobacterium tuberculosis. Of 71 patients with bronchoscopic evidence of pulmonary diseases, 30 had previous occupational exposure, and 41 stated no previous exposure. Cavitary lesions on chest radiography, positive purified protein derivative tests and high ESR were more prevalent in tuberculous patients than the others. Bronchial anthracosis was caused by active or previous tuberculous infection. Detailed examinations for the presence of active tuberculosis should be performed in patients with such bronchoscopic findings in order to prevent the spread of tuberculosis and to avoid unnecessary invasive procedures.

General anesthesia in a patient with known bronchial anthracofibrosis -A case report-

Bronchial anthracosis was recently defined in the English radiology literature as a luminal narrowing associated with anthracotic pigmentation on bronchoscopy without a relevant history of pneumoconiosis or smoking. Anthracosis refers to the presence of carbon particles in the lungs, not to a disorder per se. Anthracofibrotic lesions carry the potential risk of massive hemorrhage during endobronchial procedures. This report describes a case of general anesthesia for a left modified radical mastectomy due to an intraductal carcinoma in a patient with known bronchial anthracofibrosis.