CTICasesPulmonary Anthracofibrosis
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Imaging findings
Chest radiograph reveals bilateral interstitial and nodular opacities, primarily in the lower lobes. Chest CT shows a left-sided pleural effusion, numerous perilymphatic and random pulmonary nodules, and a prominent, highly nodular fibrotic band traversing the right lower lobe, mimicking lymphangitic carcinomatosis. A PET-CT demonstrates that some of these nodular lesions are avidly FDG-active. Biopsy of the lower lobe nodules confirmed benign anthracofibrosis with pigmentation and fibrotic scarring.
Key takeaways
Anthracofibrosis is a chronic inflammatory and fibrotic disease of the airways associated with dark carbon pigmentation and scarring, typically seen in miners, welders, or individuals with chronic exposure to biomass smoke or mineral dusts like silica. It can closely mimic lymphangitic carcinomatosis or metastatic disease on chest radiographs and CT, and the lesions can be false-positive (avidly FDG-hot) on PET-CT, requiring biopsy for definitive diagnosis.
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