1. bookVolumen 59 (2021): Edición 4 (December 2021)
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Revista
eISSN
2501-062X
Primera edición
30 Mar 2015
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4 veces al año
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access type Acceso abierto

Imaging characteristics of nontuberculous mycobacterial pulmonary nodules

Publicado en línea: 20 Nov 2021
Volumen & Edición: Volumen 59 (2021) - Edición 4 (December 2021)
Páginas: 369 - 374
Recibido: 11 Feb 2021
Detalles de la revista
License
Formato
Revista
eISSN
2501-062X
Primera edición
30 Mar 2015
Calendario de la edición
4 veces al año
Idiomas
Inglés
Abstract

Introduction. Nontuberculous mycobacteriosis (NTM) of the lungs can develop nodules. In order to clarify some of the characteristics of lung NTM nodules, we examined volume doubling time (VDT) and maximum standardized uptake value (SUVmax) in positron emission tomography (PET) of pathologically diagnosed NTM nodules.

Methods. From November 2012 to August 2018, clinical and radiological information were retrospectively investigated in eight patients who were surgically resected and diagnosed as NTM. These eight patients were followed up until November 2020 and were confirmed to have no appearance of lung cancer or reappearance of lung NTM nodules. The VDT was calculated using the Schwartz formula.

Results. The median maximum diameter of the nodule at the time of the first CT scan was 16.0 (range: 9.9–20.0) mm. The median maximum diameter of the nodule on CT performed before the surgical biopsy was 18.8 (range: 10.4–32.8) mm. The median doubling time calculated from these results was 203 (range: 20–568) days. Caseous granulomas and acid-fast bacilli were histologically confirmed in all eight patients. Culture of excised nodules revealed Mycobacterium intracellulare in five patients and Mycobacterium avium in three patients. Six patients received PET, and median SUVmax was: 7.0 (range: 3.3–21.0). Median VDT was around 200 days. Some patients had irregular-shaped nodules.

Conclusions. CT/PET-CT characteristics of lung nodules are not reliable in differentiating lung NTM nodules from malignant ones. To avoid unnecessary resection, it may be better to collect various information on imaging findings in the nodule itself and in opacities other than the nodule.

Keywords

1. LYNCH DA, SIMONE PM, FOX MA, BURCHER BL, HEINIG MJ. CT features of pulmonary Mycobacterium avium complex infection. J Comput Assist Tomogr. 1995; 19(3): 353–60.10.1097/00004728-199505000-00003 Search in Google Scholar

2. MOORE EH. Atypical mycobacterial infection in the lung: CT appearance. Radiology. 1993; 187(3): 777–82.10.1148/radiology.187.3.8497629 Search in Google Scholar

3. TANAKA E, AMITANI R, NIIMI A, SUZUKI K, MURAYAMA T, KUZE F. Yield of CT and bronchoscopy for the diagnosis of Mycobacterium avium complex pulmonary disease. Am J Respir Crit Care Med. 1997; 155(6): 2041–6.10.1164/ajrccm.155.6.9196113 Search in Google Scholar

4. OBAYASHI Y, FUJITA J, SUEMITSU I, KAMEI T, NII M, TAKAHARA J. Successive follow-up of chest computed tomography in patients with Mycobacterium avium-intracellulare complex. Respir Med. 1999; 93(1): 11–15.10.1016/S0954-6111(99)90070-7 Search in Google Scholar

5. HONG SJ, KIM TJ, LEE JH, PARK JS. Nontuberculous mycobacterial pulmonary disease mimicking lung cancer: Clinicoradiologic features and diagnostic implications. Medicine (Baltimore). 2016; 95(26): e3978.10.1097/MD.0000000000003978493791027367996 Search in Google Scholar

6. NAVID S, ARZHANG S, MIRZAEI A, KEFAYAT A, NADERI Z. Misleading of the diagnosis of Mycobacterium attributed lung diseases to malignancy due to smear, culture and PCR negative results: A lesson from a case report. Indian J Tuberc. 2020; 67(3): 371–3.10.1016/j.ijtb.2019.09.00232825871 Search in Google Scholar

7. FOGLA S, PANSARE VM, CAMERO LG, SYEDA U, PATIL N, CHAUDHURY A. Cavitary lung lesion suspicious for malignancy reveals Mycobacterium xenopi. Respir Med Case Rep. 2018 Jan 3; 23: 83–5.10.1016/j.rmcr.2017.12.011576046629326867 Search in Google Scholar

8. MEIER E, PENNINGTON K, GALLO DE MORAES A, ESCALANTE P. Characteristics of Mycobacterium avium complex (MAC) pulmonary disease in previously treated lung cancer patients. Respir Med Case Rep. 2017 Jun 23; 22: 70–3.10.1016/j.rmcr.2017.06.012549175828702340 Search in Google Scholar

9. TEH RW, FEENEY K, FRANCIS RJ, PHILLIPS M, MILLWARD MJ. Mycobacterium mimicking metastatic melanoma. Intern Med J. 2013; 43(12): 1342–6.10.1111/imj.1220924330366 Search in Google Scholar

10. BAE K, JUNG H, JEON KN, HYUN SD, KIM SH, KIM HC. Coexistence of nontuberculous mycobacterium and IgG4-related disease in a solitary pulmonary nodule: A case report. Medicine (Baltimore). 2019; 98(48): e18179.10.1097/MD.0000000000018179689035931770270 Search in Google Scholar

11. GARG N, PUNCH C, STEIN M, SCHOFIELD C. When occam’s razor can fail- active mycobacteria infection and lung cancer: A case of neuroendocrine lung cancer diagnosed in the setting of refractory mycobacterium avium-intracellulare. Clin Case Rep. 2018; 6(11): 2156–9.10.1002/ccr3.1813 Search in Google Scholar

12. MATSUMOTO A, ENOMOTO T, MUROYA Y, SUGISAKI M, SHINGU A, SAITOH H, et al. Pulmonary non-tuberculous mycobacteriosis (Mycobacterium intracellulare) with cavities developing in a non-small cell lung cancer patient during chemotherapy. Nihon Kokyuki Gakkai Zasshi. 2010; 48(8): 609–13. Search in Google Scholar

13. NAKAMURA Y, OKADA Y, ENDO C, AIKAWA H, SAKURADA A, SATO M, et al. Endobronchial carcinoid tumor combined with pulmonary non-tuberculous mycobacterial infection: report of two cases. Lung Cancer. 2003; 39(2): 227–9.10.1016/S0169-5002(02)00450-6 Search in Google Scholar

14. KAWATE E, YAMAZAKI M, KOHNO T, FUJIMORI S, TAKAHASHI H. Two cases with solitary pulmonary nodule due to non-tuberculous mycobacterial infection showing intense 18F-fluorodeoxyglucose uptake on positron emission tomography scan. Geriatr Gerontol Int. 2010; 10(3): 251–4.10.1111/j.1447-0594.2010.00619.x Search in Google Scholar

15. MIN Z, AMLANI M. Pulmonary Mycobacterium kansasii Infection Mimicking Malignancy on the (18) F-FDG PET Scan in a Patient Receiving Etanercept: A Case Report and Literature Review. Case Rep Pulmonol. 2014; 2014: 973573. Search in Google Scholar

16. LINDELL RM, HARTMAN TE, SWENSEN SJ, JETT JR, MIDTHUN DE, TAZELAAR HD, et al. Five-year lung cancer screening experience: CT appearance, growthrate, location, and histologic features of 61 lung cancers. Radiology. 2007; 242(2): 555–62.10.1148/radiol.2422052090 Search in Google Scholar

17. HONDA O, JOHKOH T, SEKIGUCHI J, TOMIYAMA N, MIHARA N, SUMIKAWA H, et al. Doubling time of lung cancer determined using three-dimensional volumetric software: comparison of squamous cell carcinoma and adenocarcinoma. Lung Cancer. 2009; 66(2): 211–7.10.1016/j.lungcan.2009.01.018 Search in Google Scholar

18. ODA S, AWAI K, MURAO K, OZAWA A, UTSUNOMIYA D, YANAGA Y, et al. Volume-doubling time of pulmonary nodules with ground glass opacity at multidetector CT: assessment with computer-aided three-dimensional volumetry. Acad Radiol. 2011; 18(1): 63–9.10.1016/j.acra.2010.08.022 Search in Google Scholar

19. SCHWARTZ M. A biomathematical approach to clinical tumor growth. Cancer. 1961; 14: 1272–94.10.1002/1097-0142(196111/12)14:6<1272::AID-CNCR2820140618>3.0.CO;2-H Search in Google Scholar

20. BUDAK E, ÇOK G, AKGUN A. The Contribution of Fluorine (18)F-FDG PET/CT to Lung Cancer Diagnosis, Staging and Treatment Planning. Mol Imaging Radionucl Ther. 2018; 27(2): 73–80.10.4274/mirt.53315 Search in Google Scholar

21. AL-SARRAF N, GATELY K, LUCEY J, AZIZ R, DODDAKULA K, WILSON L, et al. Clinical implication and prognostic significance of standardised uptake value of primary non-small cell lung cancer on positron emission tomography: analysis of 176 cases. Eur J Cardiothorac Surg. 2008; 34(4): 892–7.10.1016/j.ejcts.2008.07.023 Search in Google Scholar

22. USUDA K, SAGAWA M, MOTONO N, UEDA M, TANAKA M, MACHIDA Y, et al. Diagnostic performance of diffusion weighted imaging of malignant and benign pulmonary nodules and masses: comparison with positron emission tomography. Asian Pac J Cancer Prev. 2014; 15(11): 4629–35.10.7314/APJCP.2014.15.11.4629 Search in Google Scholar

23. CHRYSIKOS S, GKIOZOS I, DIMAKOU K, ZERVAS E, KAARAMPITSAKOS T, ANYFANTI M, et al. Clinical utility of thoracic endosonography (EBUS/EUS-b) in mediastinal staging of patients with non-small cell lung cancer: comparison with integrated PET/CT-a real-life prospective study in Greece. J Thorac Dis. 2020; 12(10): 5657–66.10.21037/jtd-20-1735765638533209398 Search in Google Scholar

24. ZHOU LM, YUAN LL, GAO Y, LIU XS, DAI Q, YANG JW, et al. Nucleophosmin 1 overexpression correlates with (18)F-FDG PET/CT metabolic parameters and improves diagnostic accuracy in patients with lung adenocarcinoma. Eur J Nucl Med Mol Imaging. 2020 Aug 27. doi: 10.1007/s00259-020-05005-4.10.1007/s00259-020-05005-432856112 Search in Google Scholar

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