Surgical resection is sufficient for incidentally discovered solitary pulmonary nodule caused by nontuberculous mycobacteria in asymptomatic patients
Autoři:
Hung-Ling Huang aff001; Chia-Jung Liu aff004; Meng-Rui Lee aff004; Meng-Hsuan Cheng aff002; Po-Liang Lu aff002; Jann-Yuan Wang aff005; Inn-Wen Chong aff002
Působiště autorů:
Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
aff001; Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
aff002; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
aff003; Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu, Taiwan
aff004; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
aff005; National Taiwan University, College of Medicine, Taipei, Taiwan
aff006; Departments of Respiratory Therapy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
aff007; Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
aff008
Vyšlo v časopise:
PLoS ONE 14(9)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0222425
Souhrn
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.
Klíčová slova:
Biology and life sciences – Organisms – Bacteria – Actinobacteria – Nontuberculous mycobacteria – Mycobacterium avium complex – Mycobacterium tuberculosis – Anatomy – Body fluids – Mucus – Sputum – Physiology – Neuroscience – Neuroimaging – Medicine and health sciences – Surgical and invasive medical procedures – Surgical resection – Lung resection – Respiratory system procedures – Diagnostic medicine – Diagnostic radiology – Tomography – Computed axial tomography – Radiology and imaging – Research and analysis methods – Imaging techniques – Specimen preparation and treatment
Zdroje
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