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Kim, Lee, Nam, Lim, Jung, and Ryu: The Clinical Significance of Bronchial Anthracofibrosis Associated with Coal Workers' Pneumoconiosis
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2010; 68(2): 67-73.

Published online: 28 February 2010

DOI: https://doi.org/10.4046/trd.2010.68.2.67

The Clinical Significance of Bronchial Anthracofibrosis Associated with Coal Workers' Pneumoconiosis

Mi Hye Kim, M.D.1, Hong Yeul Lee, M.D.1, Ki Ho Nam, M.D.1, Jae Min Lim, M.D.1, Bock Hyun Jung, M.D.1, Dae Sick Ryu, M.D.2

1Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.

2Department of Radiology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.

Address for correspondence: Bock Hyun Jung, M.D. Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, 415, Bangdong-ri, Sacheon-myun, Gangneung 210-711, Korea. Phone: 82-33-610-3319, Fax: 82-33-641-8066, jbh@gnah.co.kr

Received 4 November 2009       Accepted 11 January 2010

Copyright © 2010. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Background

In previous study, most patients with bronchial anthracofibrosis (BAF) were non-miners, and non-occupational old aged females. However, the clinical significance of BAF in patients with coal workers' pneumoconiosis (CWP) is unknown.

Methods

Among patients with CWP who transferred to our hospital for an evaluation of associated pulmonary diseases, 32 patients who had undergone a bronchofibroscopy (BFS) and chest computed tomography (CT) examination were evaluated for the association of the BAF using a retrospective chart review.

Results

Nine of the 32 CWP patients (28%) were complicated with BAF. Four of the 16 simple CWP patients (25%) were complicated with BAF. According to the International Labor Organization (ILO) classification by profusion, 2 out of 3 patients in category 1, 1 out of 8 patients in category 2 and 1 out of 3 patients in category 3 were complicated with BAF. Five out of 16 complicated CWP patients were complicated with BAF. Three out of 7 patients in type A and 2 out of 5 patients in type C were complicated with BAF. CWP patients with BAF had significantly greater multiple bronchial thickening and multiple mediastinal or hilar lymph node enlargement than the CWP patients without BAF. There was no difference in the other clinical features between the CWP patients with BAF and those without BAF.

Conclusion

Many CWP patients were complicated with BAF. The occurrence of BAF was not associated with the severity of CWP progression. Therefore, a careful evaluation of the airway with a bronchoscopy examination and chest CT is warranted for BAF complicated CWP patients who present with respiratory symptoms and signs, even ILO class category 1 simple CWP patients.

Keywords: Pneumoconiosis, Bronchoscopy, Bronchial Anthracofibrosis

Figures and Tables

Figure 1
70-year-old man with coal workers' pneumoconiosis associated with bronchial anthracofibrosis. (A) Contrast enhanced CT shows bronchial wall thickening due to enlarged lymph node and peribronchial fibrosis. (B) Lung setting on CT shows multiple p type nodules in the both upper lobes. (C) Flexible bronchoscopy shows bronchial narrowing with engorged mucosal vessel and anthracotic pigmentation in the right upper lobe bronchus. (D) Anthracotic pigmentation and bronchial stenosis is also noted in the right middle lobe bronchus.
trd-68-67-g001
Table 1
Demographics and clinical features of 32 patients with coal workers' pneumoconiosis
trd-68-67-i001

CWP: coal workers' penumoconiosis; PMF: progressive massive fibrosis.

Table 2
The difference of clinical characteristics between coal workers' pneumoconiosis with and without bronchial anthracofibrosis
trd-68-67-i002

CWP: coal workers' pneumoconiosis; BAF: bronchial anthracofibrosis.

*p=0.053.

Table 3
The difference of the CT findings between coal workers' pneumoconiosis with and without bronchial anthracofibrosis
trd-68-67-i003

CWP: coal workers' pneumoconiosis; PMF: progressive massive fibrosis; BAF: bronchial anthracofibrosis.

*p<0.05.

Table 4
The concurrence rate of bronchial anthracofibrosis complicated according to ILO classification of coal workers' pneumoconiosis
trd-68-67-i004

ILO: International Labor Organization; CWP: coal workers' pneumoconiosis; BAF: bronchial anthracofibrosis.

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