Non-tuberculous mycobacterial diseases presenting as solitary pulmonary nodules

J. Lim, J. Lyu, C. M. Choi, Y. M. Oh, S. D. Lee, W. S. Kim, D. S. Kim, Hyeyoung Lee, Tae Sun Shim

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

SETTING: South Korea, 2005-2007. BACKGROUND: Non-tuberculous mycobacterial diseases presenting as solitary pulmonary nodules (NTM-SPN) are rare and may be misdiagnosed as tuberculoma. DESIGN: Eleven NTM-SPN patients were enrolled retrospectively and compared with two groups each of 33 patients with upper lobe cavitary (UC) and nodular bronchiectatic (NB) type NTM diseases, respectively. RESULTS: The patients' median age was 52 years. Compared with UC-type disease, NTM-SPN patients showed female (n = 9) and never smoker (n = 8) predominance and fewer comorbidities (n = 0; P < 0.05 for each). M ycobacterium avium (n = 9) was predominant in NTM-SPN patients, followed by M. intracellulare (n = 2), whereas M. intracellulare was most frequently isolated from patients with both UC- and NB-type NTM (P < 0.05). The nodules were a median of 2.3 cm in diameter (range 1.6-6.3 cm) and were distributed evenly in all lobes. In all patients, percutaneous needle aspiration/ biopsy was performed with a median 71 days of diagnostic delay. Ten patients successfully completed treatment, and one showed spontaneous reduction of nodule size without treatment. Reverse blot hybridisation assays of six DNA samples identified four subjects with M. avium-intracellulare complex (MAC), in line with conventional test data. CONCLUSION: NTM-SPN was caused exclusively by MAC. Although clinical outcome was favourable, confirmatory diagnosis was delayed. Molecular methods are needed for early diagnosis of NTM-SPN.

Original languageEnglish
Pages (from-to)1635-1640
Number of pages6
JournalInternational Journal of Tuberculosis and Lung Disease
Volume14
Issue number12
Publication statusPublished - 2010 Dec 1

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Solitary Pulmonary Nodule
Needle Biopsy
Tuberculoma
Republic of Korea
Delayed Diagnosis
Diagnostic Errors
Comorbidity
Early Diagnosis

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

Cite this

Lim, J., Lyu, J., Choi, C. M., Oh, Y. M., Lee, S. D., Kim, W. S., ... Shim, T. S. (2010). Non-tuberculous mycobacterial diseases presenting as solitary pulmonary nodules. International Journal of Tuberculosis and Lung Disease, 14(12), 1635-1640.
Lim, J. ; Lyu, J. ; Choi, C. M. ; Oh, Y. M. ; Lee, S. D. ; Kim, W. S. ; Kim, D. S. ; Lee, Hyeyoung ; Shim, Tae Sun. / Non-tuberculous mycobacterial diseases presenting as solitary pulmonary nodules. In: International Journal of Tuberculosis and Lung Disease. 2010 ; Vol. 14, No. 12. pp. 1635-1640.
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abstract = "SETTING: South Korea, 2005-2007. BACKGROUND: Non-tuberculous mycobacterial diseases presenting as solitary pulmonary nodules (NTM-SPN) are rare and may be misdiagnosed as tuberculoma. DESIGN: Eleven NTM-SPN patients were enrolled retrospectively and compared with two groups each of 33 patients with upper lobe cavitary (UC) and nodular bronchiectatic (NB) type NTM diseases, respectively. RESULTS: The patients' median age was 52 years. Compared with UC-type disease, NTM-SPN patients showed female (n = 9) and never smoker (n = 8) predominance and fewer comorbidities (n = 0; P < 0.05 for each). M ycobacterium avium (n = 9) was predominant in NTM-SPN patients, followed by M. intracellulare (n = 2), whereas M. intracellulare was most frequently isolated from patients with both UC- and NB-type NTM (P < 0.05). The nodules were a median of 2.3 cm in diameter (range 1.6-6.3 cm) and were distributed evenly in all lobes. In all patients, percutaneous needle aspiration/ biopsy was performed with a median 71 days of diagnostic delay. Ten patients successfully completed treatment, and one showed spontaneous reduction of nodule size without treatment. Reverse blot hybridisation assays of six DNA samples identified four subjects with M. avium-intracellulare complex (MAC), in line with conventional test data. CONCLUSION: NTM-SPN was caused exclusively by MAC. Although clinical outcome was favourable, confirmatory diagnosis was delayed. Molecular methods are needed for early diagnosis of NTM-SPN.",
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Lim, J, Lyu, J, Choi, CM, Oh, YM, Lee, SD, Kim, WS, Kim, DS, Lee, H & Shim, TS 2010, 'Non-tuberculous mycobacterial diseases presenting as solitary pulmonary nodules', International Journal of Tuberculosis and Lung Disease, vol. 14, no. 12, pp. 1635-1640.

Non-tuberculous mycobacterial diseases presenting as solitary pulmonary nodules. / Lim, J.; Lyu, J.; Choi, C. M.; Oh, Y. M.; Lee, S. D.; Kim, W. S.; Kim, D. S.; Lee, Hyeyoung; Shim, Tae Sun.

In: International Journal of Tuberculosis and Lung Disease, Vol. 14, No. 12, 01.12.2010, p. 1635-1640.

Research output: Contribution to journalArticle

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T1 - Non-tuberculous mycobacterial diseases presenting as solitary pulmonary nodules

AU - Lim, J.

AU - Lyu, J.

AU - Choi, C. M.

AU - Oh, Y. M.

AU - Lee, S. D.

AU - Kim, W. S.

AU - Kim, D. S.

AU - Lee, Hyeyoung

AU - Shim, Tae Sun

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N2 - SETTING: South Korea, 2005-2007. BACKGROUND: Non-tuberculous mycobacterial diseases presenting as solitary pulmonary nodules (NTM-SPN) are rare and may be misdiagnosed as tuberculoma. DESIGN: Eleven NTM-SPN patients were enrolled retrospectively and compared with two groups each of 33 patients with upper lobe cavitary (UC) and nodular bronchiectatic (NB) type NTM diseases, respectively. RESULTS: The patients' median age was 52 years. Compared with UC-type disease, NTM-SPN patients showed female (n = 9) and never smoker (n = 8) predominance and fewer comorbidities (n = 0; P < 0.05 for each). M ycobacterium avium (n = 9) was predominant in NTM-SPN patients, followed by M. intracellulare (n = 2), whereas M. intracellulare was most frequently isolated from patients with both UC- and NB-type NTM (P < 0.05). The nodules were a median of 2.3 cm in diameter (range 1.6-6.3 cm) and were distributed evenly in all lobes. In all patients, percutaneous needle aspiration/ biopsy was performed with a median 71 days of diagnostic delay. Ten patients successfully completed treatment, and one showed spontaneous reduction of nodule size without treatment. Reverse blot hybridisation assays of six DNA samples identified four subjects with M. avium-intracellulare complex (MAC), in line with conventional test data. CONCLUSION: NTM-SPN was caused exclusively by MAC. Although clinical outcome was favourable, confirmatory diagnosis was delayed. Molecular methods are needed for early diagnosis of NTM-SPN.

AB - SETTING: South Korea, 2005-2007. BACKGROUND: Non-tuberculous mycobacterial diseases presenting as solitary pulmonary nodules (NTM-SPN) are rare and may be misdiagnosed as tuberculoma. DESIGN: Eleven NTM-SPN patients were enrolled retrospectively and compared with two groups each of 33 patients with upper lobe cavitary (UC) and nodular bronchiectatic (NB) type NTM diseases, respectively. RESULTS: The patients' median age was 52 years. Compared with UC-type disease, NTM-SPN patients showed female (n = 9) and never smoker (n = 8) predominance and fewer comorbidities (n = 0; P < 0.05 for each). M ycobacterium avium (n = 9) was predominant in NTM-SPN patients, followed by M. intracellulare (n = 2), whereas M. intracellulare was most frequently isolated from patients with both UC- and NB-type NTM (P < 0.05). The nodules were a median of 2.3 cm in diameter (range 1.6-6.3 cm) and were distributed evenly in all lobes. In all patients, percutaneous needle aspiration/ biopsy was performed with a median 71 days of diagnostic delay. Ten patients successfully completed treatment, and one showed spontaneous reduction of nodule size without treatment. Reverse blot hybridisation assays of six DNA samples identified four subjects with M. avium-intracellulare complex (MAC), in line with conventional test data. CONCLUSION: NTM-SPN was caused exclusively by MAC. Although clinical outcome was favourable, confirmatory diagnosis was delayed. Molecular methods are needed for early diagnosis of NTM-SPN.

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