CT differentiation of anthracofibrosis from endobronchial tuberculosis.
OBJECTIVE
The purpose of this study was to use CT to differentiate anthracofibrosis from endobronchial tuberculosis (TB), both of which are major causes of benign bronchostenosis.


METHODS
We retrospectively reviewed the clinical and CT findings of 49 patients with anthracofibrosis and 35 patients with endobronchial TB diagnosed on the basis of bronchoscopic, microbiologic, and pathologic findings. Forty-five patients with anthracofibrosis and 32 patients with endobronchial TB had bronchostenosis on CT and were enrolled in the analysis. Nine (20%) of 45 patients with anthracofibrosis had coexistent active TB (two, endobronchial TB; six, pulmonary TB; one, TB pleurisy), and 13 (29%) had pulmonary infections other than TB. Two patients with anthracofibrosis and coexistent endobronchial TB were excluded from the analysis. The CT findings were analyzed with emphasis on the pattern, distribution, and location of bronchostenosis and the number of pulmonary lobes involved.


RESULTS
Anthracofibrosis was more common than endobronchial TB among elderly patients (p < 0.05). Statistically significant findings on CT were the pattern of bronchostenosis, presence of main bronchus involvement, and number of pulmonary lobes involved (p < 0.05). Bronchostenosis with anthracofibrosis usually involves multiple lobar or segmental bronchi. The main bronchus, however, tends to be preserved in anthracofibrosis. Most cases of endobronchial TB involve one lobar bronchus and the ipsilateral main bronchus with contiguity in extent.


CONCLUSIONS
Anthracofibrosis can be differentiated from endobronchial TB on CT. Furthermore, CT is helpful in the diagnosis of anthracofibrosis before bronchoscopy is performed.
Department of Radiology, Kangnam St. Mary's Hospital, College of Medicine, Catholic University of Korea, 505 Banpo-dong Seocho-gu, Seoul 137-040, South Korea.
Hyun Jin
HJ
Park
Seog Hee
SH
Park
Soo Ah
SA
Im
Young Kyoon
YK
Kim
Kyo-Young
KY
Lee
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000874:Anthracosilicosis / Q000000981:diagnostic imaging*; D001982:Bronchial Diseases / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging*