Nontuberculous mycobacterial pulmonary infection in immunocompetent patients: Comparison of thin-section CT and histopathologic findings
Nontuberculous mycobacterial pulmonary infection in immunocompetent patients: Comparison of thin-section CT and histopathologic findings
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DOI：
10.1148/radiol.2313030833
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发表时间：
2004-06-01
期刊：
影响因子：
19.7
通讯作者：
Kwon, OJ
中科院分区：
文献类型：
--
作者：
Jeong, YJ;Lee, KS;Kwon, OJ
目得：识别和描述的薄层，计算机断层扫描（CT）的结果，非结核分枝杆菌（NTM）肺部感染的免疫功能正常的patients，并比较这些结果与组织病理学findings.MATERIALS AND METHODS：在2002年4月和2003年3月之间，薄层胸部CT表现和组织病理学肺组织标本22例谁满足美国胸科学会。对NTM的诊断标准进行回顾性分析。肺部病变模式，将经支气管肺活检（n = 22）或肺叶切除术（n = 1）的CT所见（即肺部感染小结节、分支小叶中心结节[即树芽样]、实变、空洞、支气管扩张和容量丢失）与组织病理学结果进行比较。22例患者中，13例发现肺结核分枝杆菌感染，7例发现鸟-细胞内分枝杆菌复合体感染，2例发现偶发分枝杆菌感染。无论具体的感染性分枝杆菌种属如何，活检部位最常见的CT表现为双侧小结节（22个[100%]肺部位）、圆柱形支气管扩张（20个[91%]部位）和分支状小叶中心结节病变（17个[77%]部位）。所有经支气管肺活检标本在组织病理学分析中均显示细支气管壁增厚以及细支气管和细支气管周围炎症。扩张的细支气管被确定在19（86%）的患者，和上皮样肉芽肿有或无干酪化被认为是在7（32%）。结论：无论具体的感染性分枝杆菌物种，最常见的薄层CT表现NTM肺部感染是双边小结节，圆柱形支气管扩张，和分支小叶中心结节。这些结果在组织病理学上与细支气管扩张、细支气管和细支气管周围炎症（伴或不伴肉芽肿形成）相对应。(C)RSNA，2004年。
PURPOSE: To identify and describe the thin-section,computed tomographic (CT) findings of nontuberculous mycobacterial (NTM) pulmonary infection in immuno-competent patients and to compare these findings with histopathologic findings.MATERIALS AND METHODS: Between April 2002 and March 2003, the thin-section chest CT findings in and histopathologic lung tissue specimens from 22 patients who fulfilled the American Thoracic Society. diagnostic criteria for NTM were retrospectively reviewed. The lung lesion patterns, (ie, pulmonary infection small nodules, branching centrilobular nodules, [ie, tree-in-bud pattern], consolidation, cavities, bronchiectasis, and volume loss) seen at CT at the sites of transbronchial lung biopsy (n = 22) or lobectomy (n = 1) were compared with the histopathologic findings.RESULTS: Thirteen of, the 22 patients were found to have Mycobacterium abscessus pulmonary infection; seven, to have Mycobacterium avium-intracellulare complex infection; and two, to have Mycobacterium fortuitum infection. Regardless of the specific infective mycobacterial species, bilateral small nodules (in 22 [100%] lung locations), cylindric bronchiectasis (in 20 [91%] locations), and branching centrilobular nodular lesions (in 17 [77%] locations) were the most common CT findings seen at the biopsy sites. All of the transbronchial lung biopsy specimens showed a thickened bronchiolar wall and bronchiolar and peribronchiolar inflammation at histopathologic analysis. Dilated bronchioles were identified in 19 (86%) patients, and epithelioid granulomas with or without caseation were seen in seven (32%).CONCLUSION: Regardless of the specific infective mycobacterial species, the most common thin-section CT findings of NTM pulmonary infection are bilateral small nodules, cylindric bronchiectasis, and branching centrilobular nodules. These findings correspond histopathologically to bronchiolectasis and bronchiolar and peribronchiolar inflammation with or without granuloma formation. (C) RSNA, 2004.