بررسي آنتراكوفيبروز ريه و بيماري سل در بيماران بستري در بيمارستان قايم مشهد، سالهاي 78-1377

Tuberculous Bronchostenosis Presenting as Anthracofibrosis

Anthracofibrosis is defined as bronchoscopic findings of bronchial stenosis or obliteration with black pigmentation on overlying mucosa. The aims of this study were to define the clinical characteristics of the patients with bronchoscopic features of Anthracofibrosis and to determine the relation between Anthracofibrosis with tuberculosis. We reviewed the records of 1118 patients who underwent fiberoptic bronchoscopy at Ghaern Hospital, Mashhad University of Medical Sciences from March 98 to February 2000. Anthrocofibrosis was diagnosed on the basis of bronchoscopic findings in 29 patients, 9 men and 20 women ranging in age from 52-90 years (mean 71 years). All of them proved to have tuberculous bronchial stenosis. The chief complaints of all patients were cough (29/29) with variable amount of sputum. Dyspneas on exertion seen in 15/29 while fever and constitutional symptoms were infrequent (<25%). Anthrocofibrosis (24/S29) most frequently involved the right upper lobe bronchus while combination of bronchi were involved and narrowed in 23 patients. In all patients tuberculosis was confirmed either by the presence of ranulomatous inflammation in biopsy specimens (17/29) or positive smear and culture of bronchial washing for acid fast bacilli (15/29). Pathologic specimens obtained by bronchoscopic biopsy showed bronchial inflammation and fibrosis with interspersed anthracotic pigments. In conclusion: Tuberculous bronchial stenosis can cause anthracotic pigmentation in the mucosa and fibrosis of bronchi in response to infection. Detailed work up for the presence of tuberculosis should be performed in all patients with bronchoscopic findings of Anthracofibrosis in order to avoid unnecessary procedures.