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THORACIC IMAGING Table of Contents   
Year : 2018  |  Volume : 28  |  Issue : 3  |  Page : 333-341
Bronchial anthracofibrosis: The spectrum of radiological appearances

1 Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi; Senior Consultant, Department of Pulmonary and Sleep Medicine, Max Super Speciality Hospital, Shalimar Bagh, New Delhi, India
2 Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
3 Department of Imaging, Max Super Speciality Hospital, Saket, New Delhi, India

Correspondence Address:
Prof. Ashok Shah
F-168/E, Rajouri Garden, New Delhi - 110 027
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijri.IJRI_339_17

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Bronchial anthracofibrosis (BAF), caused by long-standing exposure to biomass fuel smoke, has emerged as a distinct pulmonary disease. It is usually seen in elderly females who have worked long hours in poorly ventilated kitchen full of smoke due to incomplete combustion of biomass fuel. The diagnosis is confirmed on bronchoscopic visualization of bluish-black anthracotic pigmentation along with narrowing/distortion of the affected bronchus. BAF has been associated with clinical conditions such as pulmonary tuberculosis, chronic obstructive pulmonary disease, pneumonia, and malignancy. Tuberculosis, once thought to be the causative agent for BAF, is now considered to be an association. BAF has a diverse radiological presentation and the presence of associated clinical conditions often confound the radiological picture. The imaging features of BAF include primary imaging characteristics, which pertains to the disease entity directly, and secondary features based on the presence of associated conditions. High-resolution computed tomography findings of multifocal bronchial narrowing and peribronchial cuffing are considered to be specific diagnostic features of BAF. In addition, the diagnostic probability is increased in the presence of mediastinal adenopathy and collapse/atelectasis with middle lobe syndrome being the most common presentation. This pictorial essay highlights the range of imaging appearances in patients with BAF.

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