open access

Vol 85, No 3 (2017)
ORIGINAL PAPERS
Published online: 2017-06-30
Submitted: 2017-03-15
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Occurrence of bronchial anthracofibrosis in respiratory symptomatics with exposure to biomass fuel smoke

Vikas Pilaniya, Shekhar Kunal, Ashok Shah
DOI: 10.5603/ARM.2017.0022
·
Adv Respir Med 2017;85(3):127-135.

open access

Vol 85, No 3 (2017)
ORIGINAL PAPERS
Published online: 2017-06-30
Submitted: 2017-03-15

Abstract

INTRODUCTION: 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.

MATERIAL AND METHODS: 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).

RESULTS: 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.

CONCLUSIONS: 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.

 

 

Abstract

INTRODUCTION: 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.

MATERIAL AND METHODS: 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).

RESULTS: 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.

CONCLUSIONS: 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.

 

 

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Keywords

anthracosis, biomass fuel smoke, bronchial anthracofibrosis, fiberoptic bronchoscopy, high resolution computed tomography of the thorax

About this article
Title

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

Journal

Advances in Respiratory Medicine

Issue

Vol 85, No 3 (2017)

Pages

127-135

Published online

2017-06-30

DOI

10.5603/ARM.2017.0022

Bibliographic record

Adv Respir Med 2017;85(3):127-135.

Keywords

anthracosis
biomass fuel smoke
bronchial anthracofibrosis
fiberoptic bronchoscopy
high resolution computed tomography of the thorax

Authors

Vikas Pilaniya
Shekhar Kunal
Ashok Shah

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