Original Article

Relationship between Bronchial Anthracofibrosis and Pulmonary Tuberculosis: Autopsy Findings


The purpose of this study was to evaluate the characteristics of anthracofibrosis and the relationship between bronchial anthracofibrosis (BAF) and tuberculosis during autopsy in the Iranian Legal Medicine Organization (LMO). In this cross-sectional study, 385 subjects who had died from 2007 to 2010 were examined. A questionnaire having information such as the deceased's age, sex, ethnicity, smoking status and occupation was filled out for each subject. Subjects in whom autopsied lungs revealed definite obligation, edema, bronchial stricture and dark pigmentation within mucosa were considered to have anthracofibrosis. Pulmonary tuberculosis was considered with typical granulomatous in bronchial biopsy or smear positive. During the 4-year period, we evaluated 385 cases, 48(12.5%) of whom had BAF. Of these, 60.4% were female. Mean age of subjects with anthracofibrosis was 67.08±8.4 yr. Pulmonary tuberculosis was demonstrated in 24 (50%) of cases with BAF. According to bronchi features, the anatomical distribution of BAF in 60.4% cases was multiple. Anthracofibrosis more commonly occurred in right middle lobe bronchus (47.92%). This study revealed a significant correlation between BAF and pulmonary tuberculosis (P=0.001). So, BAF is one of the infrequent symptoms of pulmonary tuberculosis. In patients with anthracofibrosis and pulmonary symptoms, TB would be taken into consideration.

Chung MP, Lee KS, Han J, Kim H, Rhee CH, Han YC, Kwon OJ. Bronchial stenosis due to anthracofibrosis. Chest 1998; 113(2): 344–50.

Kim HY, Im JG, Goo JM, Kim JY, Han SK, Lee JK, Song JW. Bronchial anthracofibrosis (inflammatory bronchial stenosis with anthracotic pigmentation). Am J Radiol 2000; 174(2):523–7.

Kim Y J, Jung C Y, Shin H W, Lee B K. Biomass smoke induced bronchial anthracofi brosis: presenting features and clinical course. Respir Med 2009; 103(5): 757–65.

Ohshima S. Studies on pulmonary anthracosis. With special reference to the mineral constitution of intrapulmonary particulate pollutants in the human lung. Acta Pathol Jpn 1990; 40: 41- 9.

Aslani J, Ghanei J, Khosravi L. Association of Tuberculosis with Anthracosis, Baqiyatallah Hospital. Tehran University Medical Journal 2002; 60:460-4. (Persian)

Mosquera JA, Rodrigo L, Gonzálvez F. The evolution of pulmonary tuberculosis in coal miners in Asturias, northern Spain. An attempt to reduce the rate over a 15-year period, 1971-1985. Eur J Epidemiol 1994; 10(3): 291- 7.

Houtmeyers E, Gosselink R, Gayan-Ramires G, Decramer M. Regulation of mucociliary clearance in health and disease. Eur Resp J 1999; 13(5): 1177–88.

Fick R B Jr, Paul E S, Merrill W W, Reynolds H Y, Loke J S O. Alterations in the antibacterial properties of rabbit pulmonary macrophages exposed to wood smoke. Am Rev Respir Dis 1984; 129(1): 76–81.

Saeedi P, Mirsadraee M. Anthracosis of lung: evaluation of potential underlying causes. J Bronchol 2005; 12(2):84-7.

Najafizadeh K, Zahirifard S, Mohammadi F, Shah Ghasempour SH, Hasan Zadeh N, Dehnad A, Halvani A, Moezi HR, Kazempour Dizaji M, Masjedi MR, Farnia P. Bronchial Anthracofibrosis or Anthracotic Bronchitis. Tanaffos 2003; 2(8): 7-11.

Mukhopadhyay S, Gal AA. Granulomatous lung disease: an approach to the differential diagnosis. Arch Pathol Lab Med 2010; 134(5):667-90.

Rivera R M, Cosio M G, Ghezzo H, Salazar M, Pérez-Padilla R. Comparison of lung morphology in COPD secondary to cigarette and biomass smoke. Int J Tuberc Lung Dis 2008; 12(8):972–9.

Kulkarni N S, Prudon B, Panditi S L, Abebe Y, Grigg J. Carbon loading of alveolar macrophages in adults and children exposed to biomass smoke particles. Sci Total Environ 2005; 345(1-3): 23–30.

Pinkerton KE, Green FH, Saiki C, Vallyathan V, Plopper CG, Gopal V, Hung D, Bahne EB, Lin SS, Ménache MG, Schenker MB. Distribution of particulate matter and tissue remodeling in the human lung. Environ Health Perspect 2000; 108(11): 1063–9.

Kim J Y, Park J S, Kang M J, Yu CG, Kim YH, Han SG, et al. Endobronchial anthracofibrosis is causally associated with tuberculosis. Korean J Intern Med 1996; 51:351–7.

Mirsadraee M, Saeedi P. Anthracosis of lung: evaluation of potential underlying causes. J Bronchol 2005; 12(2): 84–7.

Long R, Wong E, Barrie J. Bronchial anthracofibrosis and tuberculosis: CT features before and after treatment. Am J Radiol 2005; 184:S33-S6.

Chung HS, Lee JH. Bronchoscopic assessment of the evolution of endobronchial tuberculosis. Chest 2000; 117(2):385–92.

Smith KR, Samet JM, Romieu I, Bruce N. Indoor air pollution in developing countries and acute lower respiratory infections in children. Thorax 2000; 55(6): 518- 32.

Delgado L, Parra E R, Capelozzi V L. Apoptosis and extracellular matrix remodeling in human silicosis. Histopathology 2006; 49(3): 283–9.

Thibodeau M, Giardina C, Hubbard A K. Silica-induced caspase activation in mouse alveolar macrophages is dependent upon mitochondrial integrity and aspartic proteolysis. Toxicol Sci 2003; 76(1): 91–101.

Shen H M, Zhang Z, Zhang Q F, Ong C N. Reactive oxygen species and caspase activation mediate silica-induced apoptosis in alveolar macrophages. Am J Physiol Lung Cell Mol Physiol 2001; 280(1): L10–L7.

International Institute for Population Sciences. National family health survey (MCH and Family Planning): India 1992–93. Bombay, India: IIPS, 1995.

Im JG, Song KS, Kang HS, Park JH, Yeon KM, Han MC, Kim CW. Mediastinal tuberculous lymphadenitis: CT manifestations. Radiology 1987; 164(1):115–9.

Kala J, Sahay S, Shah A. Bronchial anthracofibrosis and tuberculosis presenting as a middle lobe syndrome. Prim Care Resp J 2008; 17(1):51-5.

IssueVol 5 No 1 (2013) QRcode
SectionOriginal Article(s)
Anthracofibrosis Pulmonary tuberculosis Autopsy

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How to Cite
EMAMHADI M, MOSTAFAZADEH B, MASJEDI MR, BAHADORI M, SHAFIEE G. Relationship between Bronchial Anthracofibrosis and Pulmonary Tuberculosis: Autopsy Findings. Int J Occup Hyg. 2015;5(1):35-38.