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Anthracofibrosis, Bronchial Stenosis With Overlying Anthracotic Mucosa: Possibly a New Occupational Lung Disorder: A Series of Seven Cases From One UK Hospital

Gareth J. Wynn, MBChB; Peter M. Turkington, MD; B. Ronan O'Driscoll, MD
Author and Funding Information

*From the Department of Respiratory Medicine, Salford Royal University Hospital, Salford, UK.

Correspondence to: B. Ronan O'Driscoll, MD, Hope Hospital, Respiratory Medicine, Stott Ln, Salford M6 8HD, UK; e-mail: ronan.o'driscoll@srft.nhs.uk

Dr. Turkington is the Chief Investigator for a research project, with a £50,000 grant from the Pfizer Foundation, on the early diagnosis of COPD and targeted smoking cessation. He has given six lectures per year to primary care staff with honoraria from various pharmaceutical companies (AstraZeneca, GlaxoSmithKline, and Pfizer). Dr. Wynn and Dr. O'Driscoll have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2008;134(5):1069-1073. doi:10.1378/chest.08-0814
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Anthracofibrosis, which was recently defined as bronchial stenosis with overlying anthracotic mucosa, has been infrequently reported in Asia as a complication of tuberculosis (TB). It has not been reported in the United Kingdom or the United States, or, to our knowledge, in non-Asian patients. We have identified seven cases of patients presenting to a single teaching hospital in the northwest of England over a 13-year period. Only one patient had a history of TB, but six of the seven patients had a history of occupational dust exposure, including one patient with pneumoconiosis. It is possible that anthracofibrosis is an exaggerated endobronchial form of the much more common condition of anthracosis in coal miners and other workers who have been exposed to mineral dusts. Our study suggests that this is essentially a benign condition, although it may progress very slowly, leading to gradually progressive bronchial stenosis. The diagnosis is important because most patients have clinical, radiologic, and bronchoscopic changes that are highly suspicious of malignancy.

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