以右肺中叶肺不张、肺实变为主要影像表现的老年女性支气管色素沉着纤维化延迟诊治分析OACSTPCD

Objective To analyze the clinical characteristics and causes of misdiagnosis of bronchial anthracofibrosis(BAF)in patients with right middle lobe atectasis and pulmonary consolidation.Methods The diagnosis and treatment of 5 elderly BAF patients with right middle lobe atelectasis and pulmonary consolidation as the main imaging manifestations and di-agnosed by tracheoscopy were retrospectively analyzed from January to December 2023.Results Five elderly women aged 67-75 years lived in rural areas for a long period of time,and had a history of perennial biofuel use.The main clinical manifesta-tions of the 5 patients were chronic cough,chest tightness and shortness of breath after activity.Chest CT showed right middle lobe atectasis in 3 patients,right middle lobe consolidation in 2 patients,basic hypertension in 2 patients,and no smoking history in 5 patients.There was misdiagnosis as pneumonia in 1 patient,bronchial asthma in 1 patients,chronic bronchitis in 1 patient,chronic obstructive pulmonary disease in 1 patient,and lung space occupying lesion in 1 patient.Five patients were finally diagnosed with BAF by tracheoscopy,and the misdiagnosis time lasted 2 d to 20 years.Five patients received dual bronchodilator inhalation and symptomatic supportive treatment,and all were discharged from hospital.Conclusion BAF has no specific symptoms in early stage,no specificity in laboratory and imaging tests,and it is prone to misdiagnosis.The diagno-sis of the disease depends on the comprehensive judgment of history,clinical and imaging examination and tracheoscopy.For elderly female patients who have been using biofuels for cooking and heating for years and whose imaging findings suggest right middle lobe atelectasis and right middle lobe consolidation as the main signs,tracheoscopy must be performed to rule out the possibility of BAF.