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Nontuberculous Mycobacterial Pulmonary Disease mimicking Lung Cancer: Clinicoradiologic Features and Diagnostic Implications

Title
Nontuberculous Mycobacterial Pulmonary Disease mimicking Lung Cancer: Clinicoradiologic Features and Diagnostic Implications
Author
홍수진
Keywords
lung; needle biopsy; nontuberculous mycobacteria; solitary pulmonary nodule; x-ray computed tomography
Issue Date
2016-06
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Citation
MEDICINE, v.95, v.26, page.1-6
Abstract
To describe the features and clinical implications of computed tomography (CT), positron emission tomography (PET), and percutaneous needle aspiration biopsy (PCNB) in pulmonary nontuberculous mycobacterial (NTM) disease manifesting as a solitary nodule, mass, or mass-like consolidation mimicking malignancy.Among a cohort of 388 patients with NTM pulmonary disease, 14 patients with clinically and radiologically suspected lung cancer were included in our study. Two chest radiologists evaluated CT features, including lesion type (nodule, mass, or mass-like consolidation), morphologic features (margin, degree of enhancement, calcification), and presence of accompanying findings suggestive of NTM pulmonary disease (bronchiectasis with clustered centrilobular nodules or upper-lobe cavitary lesions) by consensus. Diagnostic procedures for microbiologic diagnosis of NTM disease and clinical outcome were reviewed.Incidence of NTM pulmonary disease presenting as solitary nodule/mass (n = 8) or mass-like consolidation (n = 6) was 3.6% (14 of 388). Most lesions were detected incidentally during routine health check-up or evaluation of other disease (11 of 14, 79%). Lesions typically showed poor contrast-enhancement (9 of 12) and internal calcification (6 of 14). No lesions had CT features suggestive of NTM pulmonary disease. All 4 lesions for which PET/CT imaging was performed showed strong fluorodeoxyglucose uptake simulating malignant lesions (mean, 4.9; range, 3.6-7.8). PCNB revealed mycobacterial histology in 6 of 11 specimens and positive culture results were obtained for 7 of 7 specimens.NTM pulmonary disease may present as a solitary nodule, mass, or mass-like consolidation mimicking malignancy. CT features and PCNB are important to diagnose NTM disease mimicking lung cancer to avoid unnecessary surgery.
URI
https://journals.lww.com/md-journal/Fulltext/2016/06280/Nontuberculous_mycobacterial_pulmonary_disease.22.aspxhttp://repository.hanyang.ac.kr/handle/20.500.11754/73788
ISSN
0025-7974; 1536-5964
DOI
10.1097/MD.0000000000003978
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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