title: Bronchial anthracofibrosis and tuberculosis presenting as a middle lobe syndrome.
abstract: Bronchial anthracofibrosis, a clinical entity described less than a decade ago, is characterised by anthracotic pigmentation of the bronchial mucosa with multifocal bronchial lumen narrowing. The right middle lobe is predominantly involved and is frequently associated with tuberculosis. The condition is generally seen in non-smoking elderly ladies with a longstanding history of wood smoke exposure. A 65 year-old lady presented to us with a one-month history of dry cough. The chest radiograph revealed a middle lobe syndrome which was confirmed on computed tomography (CT) scanning. In addition, narrowing of the right middle lobe bronchus was seen. This raised the suspicion of a malignancy. Fibreoptic bronchoscopy revealed anthracotic pigmentation, and bronchial aspirate showed acid fast bacilli. Culture of the aspirate grew Mycobacterium tuberculosis. The patient responded to standard antituberculous treatment.
authors.affiliation: Department of Respiratory Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, India.
authors.forename: Jaya
authors.initials: J
authors.lastname: Kala
authors.forename: Sandeep
authors.initials: S
authors.lastname: Sahay
authors.forename: Ashok
authors.initials: A
authors.lastname: Shah
mesh_terms: D000368:Aged; D001706:Biopsy; D001991:Bronchitis / Q000150:complications* / Q000000981:diagnostic imaging; D003031:Coal; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000209:etiology; D003371:Cough / Q000209:etiology; D005260:Female; D006801:Humans; D008168:Lung / Q000382:microbiology / Q000473:pathology; D008878:Middle Lobe Syndrome / Q000209:etiology*; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D010858:Pigmentation; D013183:Sputum / Q000382:microbiology*; D014057:Tomography, X-Ray Computed; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000000981:diagnostic imaging / Q000382:microbiology
chemical_list: D003031:Coal