Comparison of clinical and radiologic characteristics between anthracofibrosis and endobronchial lung cancer

There are many similarities between lung cancer and anthracofibrosis (AF), both are common and present with similar symptoms and radiological findings. This study aimed to describe the clinical radiological differentiation between AF and endobronchial lung cancer, both confirmed by bronchoscopy. This is a retrospective study of patients with AF or bronchoscopic biopsy confirmed endobronchial lung cancer from 2008 to 2014. The reviewed data were derived from a bronchoscopy registry made on January 1, 2008. We analyzed the clinical and radiological characteristics of both diseases. Among the 3214 patients who underwent bronchoscopy, 167 and 117 patients were enrolled in the AF and lung cancer groups, respectively. AF occurred more predominantly in older non-smoking female patients with a higher chance of tuberculosis (38.3%) than in those with lung cancer (6.0%). Common symptoms reported were cough, sputum, and dyspnea in both groups. Bronchoscopic findings revealed that AF lesions were more common in the multiple lobar bronchi (85.0%) or bilaterally (73.7%). Radiologic findings revealed that bronchial stenosis was the most commonly found lesion in both groups (49.1% vs. 78.6%). Rates of peribronchial calcification and bronchial wall thickening were high in the AF group. The number of patients with lymph node enlargement and calcification was also higher in the AF group. Our study demonstrated the characteristic of clinical radiologic findings in AF and endobronchial lung cancer. Increasing the awareness of both diseases may help clinicians to differentiate the diseases from each other, avoiding unnecessary invasive diagnostic procedures.