Prevalence of tuberculosis in patients with anthracosis: study on 150 subjects

A probable concordance and association between pulmonary tuberculosis and anthracosis was observed in the published literature. We conducted this study to evaluate the clinical and radiologic characteristics of patients with bronchoscopic evidence of anthracosis as well as the prevalence of pulmonary tuberculosis in patients with anthracosis.

Included in the study were 150 consecutive patients with evidence of anthracosis as evidenced by bronchoscopy. Pulmonary tuberculosis diagnostic work up which included bronchoalveolar lavage, sputum smears and cultures, or histologic examination of lung biopsies was performed on all patients. Patients' clinical, pathological, and radiological findings were also recorded and analyzed.

A total of 88 men and 62 women, ranging in age from 42 to 92 years were included in the study. Dyspnea (38.7%) and productive cough (35.3%) were among the most common chief complaints. The abnormal bronchoscopic findings were seen most frequently in the right middle lobe bronchus. In 42 patients pulmonary tuberculosis was confirmed either bacteriologically (n = 32) or histologically (n = 10). CT scans of 26 patients were examined, of which the most frequent findings were consolidation and a reticular pattern. Pleural involvement was observed in 14 patients.

Prevalence of pulmonary tuberculosis was higher among those with bronchial stenosis (P < 0.05). These findings have suggested that bronchial anthracosis, especially cases of localized anthracosis, in patients with bronchial stenosis and in those without a history of smoking or occupational exposure may be caused by tuberculosis.