Surgical resection is sufficient for incidentally discovered solitary pulmonary nodule caused by nontuberculous mycobacteria in asymptomatic patients
Journal
PLoS ONE
Journal Volume
14
Journal Issue
9
Pages
e0222425
Date Issued
2019
Author(s)
Abstract
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. ? 2019 Huang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
SDGs
Other Subjects
antimycobacterial agent; tuberculostatic agent; adult; Article; asymptomatic disease; atypical mycobacteriosis; atypical Mycobacterium; bacteriology; bacterium culture; bacterium isolation; chronic inflammation; clinical article; clinical feature; clinical outcome; cohort analysis; female; follow up; histopathology; human; human cell; human tissue; incidental finding; longitudinal study; lung granuloma; lung lobectomy; lung nodule; lung resection; male; medical history; Mycobacterium avium complex; Mycobacterium kansasii; nonhuman; recurrent disease; retrospective study; segmentectomy; Taiwan; wedge resection; aged; asymptomatic disease; atypical mycobacteriosis; atypical Mycobacterium; incidental finding; isolation and purification; lung; lung nodule; lung tuberculosis; microbiology; middle aged; Mycobacterium; pathogenicity; pathology; sputum; treatment outcome; Aged; Asymptomatic Diseases; Cohort Studies; Female; Humans; Incidental Findings; Lung; Male; Middle Aged; Mycobacterium; Mycobacterium avium Complex; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Solitary Pulmonary Nodule; Sputum; Taiwan; Treatment Outcome; Tuberculosis, Pulmonary
Publisher
Public Library of Science
Type
journal article