Clinical Characteristics and Outcomes of Surgically Resected Solitary Pulmonary Nodules Due to Nontuberculous Mycobacterial Infections
Background: Limited data are available regarding the detailed characteristics and outcomes of surgically resected nontuberculous mycobacterial (NTM) granulomas. Methods: We evaluated the characteristics of 49 NTM granulomas presenting as solitary pulmonary nodules (SPNs) between January 2007 and Dec...
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MDPI AG
2019-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/8/11/1898 |
| _version_ | 1798046216310751232 |
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| author | Yeonseok Choi Byung Woo Jhun Jhingook Kim Hee Jae Huh Nam Yong Lee |
| author_facet | Yeonseok Choi Byung Woo Jhun Jhingook Kim Hee Jae Huh Nam Yong Lee |
| author_sort | Yeonseok Choi |
| collection | DOAJ |
| description | Background: Limited data are available regarding the detailed characteristics and outcomes of surgically resected nontuberculous mycobacterial (NTM) granulomas. Methods: We evaluated the characteristics of 49 NTM granulomas presenting as solitary pulmonary nodules (SPNs) between January 2007 and December 2016. Results: Twenty-five patients (51%) were male and 27 (55%) were never-smokers. Seven (14%) patients had a history of tuberculosis. More than half (51%) of patients were asymptomatic. On chest computed tomography, the median SPN diameter was 18 mm, and approximately half of all SPNs (49%) were located in the upper lobes on chest computed tomography. NTM strain were preoperatively isolated from sputum (46%, 12/26), bronchial wash fluid (54%, 14/26), and needle biopsy specimens (12%, 3/26). <i>Mycobacterium avium</i> (71%, 22/31) was the organism most commonly isolated, followed by <i>Mycobacterium intracellulare</i> (16%, 5/31). Postoperative pneumothorax and atelectasis developed in four (8%) patients and one (2%) patient, respectively. Five patients received postoperative antibiotic therapy. Over a median follow-up period of 18.0 months, one patient with residual lesions after surgery started macrolide-based therapy due to aggravated symptoms. Conclusions: Most NTM granulomas can be treated completely by surgical resection without antibiotic therapy, and microbiological examination of surgical specimens is important for optimal management. |
| first_indexed | 2024-04-11T23:33:54Z |
| format | Article |
| id | doaj.art-ca93002d2ba74935af886fe2c7dbc8ed |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-04-11T23:33:54Z |
| publishDate | 2019-11-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-ca93002d2ba74935af886fe2c7dbc8ed2022-12-22T03:57:00ZengMDPI AGJournal of Clinical Medicine2077-03832019-11-01811189810.3390/jcm8111898jcm8111898Clinical Characteristics and Outcomes of Surgically Resected Solitary Pulmonary Nodules Due to Nontuberculous Mycobacterial InfectionsYeonseok Choi0Byung Woo Jhun1Jhingook Kim2Hee Jae Huh3Nam Yong Lee4Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaBackground: Limited data are available regarding the detailed characteristics and outcomes of surgically resected nontuberculous mycobacterial (NTM) granulomas. Methods: We evaluated the characteristics of 49 NTM granulomas presenting as solitary pulmonary nodules (SPNs) between January 2007 and December 2016. Results: Twenty-five patients (51%) were male and 27 (55%) were never-smokers. Seven (14%) patients had a history of tuberculosis. More than half (51%) of patients were asymptomatic. On chest computed tomography, the median SPN diameter was 18 mm, and approximately half of all SPNs (49%) were located in the upper lobes on chest computed tomography. NTM strain were preoperatively isolated from sputum (46%, 12/26), bronchial wash fluid (54%, 14/26), and needle biopsy specimens (12%, 3/26). <i>Mycobacterium avium</i> (71%, 22/31) was the organism most commonly isolated, followed by <i>Mycobacterium intracellulare</i> (16%, 5/31). Postoperative pneumothorax and atelectasis developed in four (8%) patients and one (2%) patient, respectively. Five patients received postoperative antibiotic therapy. Over a median follow-up period of 18.0 months, one patient with residual lesions after surgery started macrolide-based therapy due to aggravated symptoms. Conclusions: Most NTM granulomas can be treated completely by surgical resection without antibiotic therapy, and microbiological examination of surgical specimens is important for optimal management.https://www.mdpi.com/2077-0383/8/11/1898nontuberculous mycobacteriumnodulesurgerytreatment |
| spellingShingle | Yeonseok Choi Byung Woo Jhun Jhingook Kim Hee Jae Huh Nam Yong Lee Clinical Characteristics and Outcomes of Surgically Resected Solitary Pulmonary Nodules Due to Nontuberculous Mycobacterial Infections Journal of Clinical Medicine nontuberculous mycobacterium nodule surgery treatment |
| title | Clinical Characteristics and Outcomes of Surgically Resected Solitary Pulmonary Nodules Due to Nontuberculous Mycobacterial Infections |
| title_full | Clinical Characteristics and Outcomes of Surgically Resected Solitary Pulmonary Nodules Due to Nontuberculous Mycobacterial Infections |
| title_fullStr | Clinical Characteristics and Outcomes of Surgically Resected Solitary Pulmonary Nodules Due to Nontuberculous Mycobacterial Infections |
| title_full_unstemmed | Clinical Characteristics and Outcomes of Surgically Resected Solitary Pulmonary Nodules Due to Nontuberculous Mycobacterial Infections |
| title_short | Clinical Characteristics and Outcomes of Surgically Resected Solitary Pulmonary Nodules Due to Nontuberculous Mycobacterial Infections |
| title_sort | clinical characteristics and outcomes of surgically resected solitary pulmonary nodules due to nontuberculous mycobacterial infections |
| topic | nontuberculous mycobacterium nodule surgery treatment |
| url | https://www.mdpi.com/2077-0383/8/11/1898 |
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