Anthracostenosis associated with exposure to biomass smoke and presence of Mycobacterium tuberculosis.

Archivos deBronconeumología recently published a case report by Gómez-Seco et al.,1 which informed us of the presence of an entity that has been unknown in our setting until now: anthracostenosis or anthracofibrosis. In this letter, we describe a new clinical case in Spain with particularities similar to the other 3 previously mentioned cases. Our patient is a 66-year-old woman from a rural area, a nonsmoker, with no known history of tuberculosis or exposure to coal, although she had been inhaling wood fire smoke throughout her life. The patient had previously been diagnosed with middle lobe syndrome, and in 2002 she underwent lobectomy of the middle lobe due to recurrent pneumococcal infections. The patient was sent to our department in 2011 with chronic dry cough. Chest radiography revealed right hilar enlargement and atelectasis-partial condensation of the anterior segmental bronchus of the right upper lobe (RUL). Said findings were confirmed by chest CT, which also demonstrated bronchiectasis in the RUL and a right paratracheal adenopathy measuring 2 cm (Fig. 1A). Given the suspicion for bronchial carcinoma, bronchoscopy was