Solitary pulmonary nodules due to non-tuberculous mycobacteriosis among 28 resected cases

Ose, Naoko; Maeda, Hitoshi; Takeuchi, Yukiyasu; Susaki, Yoshiyuki; Kobori, Yuko; Taniguchi, Seiji; Maekura, Ryoji

doi:10.5588/ijtld.15.0819

Cited by 11 publications

(16 citation statements)

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“…In this study, MAC was the predominant causative organism of NTM-SPN (60%), which is in compatible with previous reports [9, 11, 22, 25, 26, 33]. Interestingly, M .…”

Section: Discussionsupporting

confidence: 93%

“…Interestingly, M . kansasii was more common in this study cohort than in those of previous reports [26, 27], accounting for 19% of the SPNs. This might be related to increasing M .…”

Section: Discussioncontrasting

confidence: 61%

“…NTM pulmonary infection has been demonstrated to present as SPN [11, 15, 22], with an incidence of 2% in a study conducted in South Korea [22]. The true incidence and outcome of NTM-SPN remain unclear because bacteriological confirmation of resected lung tissue has been lacking in most studies [9, 17, 22–25], and sometimes both patients with SPN and those with other radiographic patterns of lung lesions with multiple involvement have been enrolled [22, 26]. According to a literature review, we found only 74 cases of culture-confirmed and pure NTM-SPN, which were identified in six studies (Table 5) [9, 17, 22, 25–27].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, crucial information was frequently missing. Medical treatment was administered to only 19 (26%) patients, usually a regimen against TB rather than NTM [9, 26]. Nevertheless, in only 2 of the 74 cases (one of them received anti-NTM treatment after resection), recurrent nodular infiltration was discovered at the other lobe, and no bacteriological evidence of NTM recurrence was obtained [22].…”

Section: Discussionmentioning

confidence: 99%

“…During follow-up, 2 patients had subsequent different NTM isolates from sputum as initial tissue culture. The single NTM isolate from respiratory tract should be interpreted with caution under consideration of the colonization rather than true pathogen for patients with NTM-SPN [15, 26].…”

Section: Discussionmentioning

confidence: 99%

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Surgical resection is sufficient for incidentally discovered solitary pulmonary nodule caused by nontuberculous mycobacteria in asymptomatic patients

et al. 2019

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Incidentally discovered solitary pulmonary nodules (SPN) caused by nontuberculous mycobacteria (NTM) is uncommon, and its optimal treatment strategy remains uncertain. This cohort study determined the clinical characteristics and outcome of asymptomatic patients with NTM-SPN after surgical resection. Resected SPNs with culture-positive for NTM in six hospitals in Taiwan during January, 2010 to January, 2017 were identified. Asymptomatic patients without a history of NTM-pulmonary disease (PD) or same NTM species isolated from the respiratory samples were selected. All were followed until May 1, 2019. A total of 43 patients with NTM-SPN were enrolled. Mycobacterium avium complex (60%) and M. kansasii (19%) were the most common species. The mean age was 61.7 ± 13.4. Of them, 60% were female and 4% had history of pulmonary tuberculosis. The NTM-SPN was removed by wedge resection in 38 (88%), lobectomy in 3 (7%) and segmentectomy in 2 (5%). Caseating granuloma was the most common histologic feature (58%), while chronic inflammation accounts for 23%. Mean duration of the follow-up was 5.2 ± 2.8 years (median: 4.2 years [2.5–7.0]), there were no mycobacteriology recurrence or NTM-PD development. In conclusion, surgical resection is likely to curative for incidentally discovered NTM-SPN in asymptomatic patients without culture evidence of the same NTM species from respiratory specimens, and routine mycobacterium culture for resected SPN might be necessary for differentiating pulmonary tuberculosis and NTM because further treatment differs.

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“…In this study, MAC was the predominant causative organism of NTM-SPN (60%), which is in compatible with previous reports [9, 11, 22, 25, 26, 33]. Interestingly, M .…”

Section: Discussionsupporting

confidence: 93%

“…Interestingly, M . kansasii was more common in this study cohort than in those of previous reports [26, 27], accounting for 19% of the SPNs. This might be related to increasing M .…”

Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Surgical resection is sufficient for incidentally discovered solitary pulmonary nodule caused by nontuberculous mycobacteria in asymptomatic patients

et al. 2019

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Lobectomy for Suspected Lung Cancer Without Prior Diagnosis

Onwugbufor¹,

Soni²,

Predina³

et al. 2023

The Annals of Thoracic Surgery

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Application of diagnostic criteria for non-tuberculous mycobacterial disease to a case series of mycobacterial-positive isolates

Ghio

Smith

DeFlorio-Barker

et al. 2019

Journal of Clinical Tuberculosis and Other Mycobacterial Diseas

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The American Thoracic Society (ATS) and Infectious Diseases Society of America (IDSA) have provided guidelines to assist in the accurate diagnosis of lung disease caused by nontuberculous mycobacteria (NTM). These microbiologic, radiographic, and clinical criteria are considered equally important and all must be met to make the diagnosis of NTM lung disease. To assess the significance of the three criteria, each was evaluated for its contribution to the diagnosis of NTM lung disease in a case series. Laboratory reports of any specimen positive for NTM isolation were collected between January 1, 2006 and December 31, 2010 at a university medical center. Medical records were reviewed in detail using a standardized form. The total number of patients with a culture from any site positive for NTM was 297 while the number from respiratory specimens during the same period was 232 (78%). Samples from two of these patients also yielded M. tuberculosis complex and were excluded. While 128 of the remaining 230 patients (55.7%) in the cohort met the microbiologic criterion for diagnosis of NTM lung disease, 151 (65.6%) and 189 (78.3%) met the radiologic and clinical criteria respectively. Only 78 patients (33.9%) met all three criteria provided by the ATS/IDSA for diagnosis of NTM lung disease. This evaluation reaffirms that defining NTM lung disease using either one or two of the criteria provided by the 2007 ATS/IDSA guidelines may significantly overestimate the number of cases of NTM lung disease. Based on the experience of defining NTM lung disease in this case series, recommendations for modification of the ATS/IDSA guidelines are provided which include expansion of both radiologic patterns and the list of symptoms associated with NTM lung disease.

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Solitary pulmonary nodules due to non-tuberculous mycobacteriosis among 28 resected cases

Abstract: We believe that wedge resection is a valid surgical intervention for SN type NTM; additional postoperative chemotherapy is unnecessary in cases with no residual lesions in the operated lung lobe.

Cited by 11 publications

References 0 publications

Surgical resection is sufficient for incidentally discovered solitary pulmonary nodule caused by nontuberculous mycobacteria in asymptomatic patients

Surgical resection is sufficient for incidentally discovered solitary pulmonary nodule caused by nontuberculous mycobacteria in asymptomatic patients

Lobectomy for Suspected Lung Cancer Without Prior Diagnosis

Application of diagnostic criteria for non-tuberculous mycobacterial disease to a case series of mycobacterial-positive isolates

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