Wynn Gareth J, Turkington Peter M, O'Driscoll B Ronan
Department of Respiratory Medicine, Salford Royal University Hospital, Salford, UK.
Department of Respiratory Medicine, Salford Royal University Hospital, Salford, UK. Electronic address: ronan.o'
Chest. 2008 Nov;134(5):1069-1073. doi: 10.1378/chest.08-0814. Epub 2008 Jun 26.
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.
炭末纤维化最近被定义为伴有炭末沉着性黏膜的支气管狭窄,在亚洲作为肺结核(TB)的一种并发症鲜有报道。在英国或美国尚未见报道,据我们所知,在非亚洲患者中也未报道过。我们在13年期间内确定了7例在英格兰西北部一家教学医院就诊的患者。只有1例患者有结核病史,但7例患者中有6例有职业粉尘接触史,其中1例患有尘肺病。炭末纤维化可能是煤矿工人和其他接触矿物粉尘的工人中更为常见的炭末沉着病的一种夸张的支气管内形式。我们的研究表明,这本质上是一种良性疾病,尽管它可能进展非常缓慢,导致逐渐进展的支气管狭窄。诊断很重要,因为大多数患者有高度怀疑恶性肿瘤的临床、放射学和支气管镜检查改变。