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Newly detected pulmonary nontuberculous mycobacterial infection and peripheral lung cancers in patients during follow-up of idiopathic interstitial pneumonia: comparison of CT findings.

Oh SY, Kim MY, Hwang HJ, Shim TS, Choi CM, Kim SS, Kim DS - Medicine (Baltimore) (2015)

Bottom Line: Consolidation (n = 30; 85.7%; odds ratio [OR], 45) and cavities (n = 14; 40%, OR, 25) were more common in NTM-IIP (all P < 0.001).The midst of the fibrotic cysts including honeycomb cysts (n = 16; 45.7%, OR, 4.95) was more common in NTM-IIP (P = 0.006).NTM-IIP appeared larger, with more frequent consolidation and cavities, and was more likely to have been located in the midst of the fibrotic cysts including honeycomb cysts at the CT, which showed that it was older than Cancer-IIP.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Radiology and Research Institute of Radiology (SYO, MYK); Department of Pulmonary and Critical Care Medicine (TSS, C-MC, DSK); Department of Oncology (C-MC), University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea; and Hallym University College of Medicine (HJH), Hallym University, Sacred Heart Hospital, Anyang, and Department of Healthcare Management (S-SK), Cheongju University, Cheongju, South Korea.

ABSTRACT
This article describes the difference between the computed tomography (CT) findings in patients with newly detected pulmonary nontuberculous mycobacterial infection (NTM-IIP) and Cancer-IIP. We retrospectively evaluated 35 NTM-IIP and 78 Cancer-IIP patients in reference to their idiopathic interstitial pneumonia CT (n = 113), using >10 years of data. Two independent radiologists analyzed the CT characteristics and the axial location of the main opacity. The interobserver agreement was good (κ > 0.771). The NTM-IIP patients were older (P = 0.034). The median size of the main opacity in the NTM-IIP (27 mm; 11-73) was larger (19 mm; 5-60; P = 0.002). Consolidation (n = 30; 85.7%; odds ratio [OR], 45) and cavities (n = 14; 40%, OR, 25) were more common in NTM-IIP (all P < 0.001). The midst of the fibrotic cysts including honeycomb cysts (n = 16; 45.7%, OR, 4.95) was more common in NTM-IIP (P = 0.006). NTM-IIP appeared larger, with more frequent consolidation and cavities, and was more likely to have been located in the midst of the fibrotic cysts including honeycomb cysts at the CT, which showed that it was older than Cancer-IIP.

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CT images showing 4 axial locations of lung cancer. The axial location of the main opacity, as seen in the transverse image, is evaluated as the association of the tumor-like lesion with fibrotic lung cysts; mixed-up area of honeycomb cysts, reticulation, traction bronchiectasis, and emphysema. The axial location is subcategorized as (A) at the interface of fibrotic cysts and a normal lung in Cancer-IIP, (B) in the midst of fibrotic cysts in NTM-IIP, (C) within ground-glass opacity in Cancer-IIP, or (D) confined in a normal lung in NTM-IIP. Cancer-IIP = newly detected lung cancer in an idiopathic interstitial pneumonia patient, NTP-IIP = newly detected pulmonary nontuberculous mycobacterial infection.
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Figure 2: CT images showing 4 axial locations of lung cancer. The axial location of the main opacity, as seen in the transverse image, is evaluated as the association of the tumor-like lesion with fibrotic lung cysts; mixed-up area of honeycomb cysts, reticulation, traction bronchiectasis, and emphysema. The axial location is subcategorized as (A) at the interface of fibrotic cysts and a normal lung in Cancer-IIP, (B) in the midst of fibrotic cysts in NTM-IIP, (C) within ground-glass opacity in Cancer-IIP, or (D) confined in a normal lung in NTM-IIP. Cancer-IIP = newly detected lung cancer in an idiopathic interstitial pneumonia patient, NTP-IIP = newly detected pulmonary nontuberculous mycobacterial infection.

Mentions: Two chest radiologists (M.Y.K. and S.Y.O., with 18 and 4 years of experience in thoracic radiology, respectively) who were blinded to all the clinical data except those of all the IIP patients reviewed the serial 226 CT scans and determined the earliest scan that showed NTM-IIP and Cancer-IIP (113 Time1 CT; time of presentation reference to 113 Time0 CT; no main opacity). The randomly mixed 113 Time1 CT scans were independently analyzed with regard to the CT characteristics, that is, the main opacity (size, 3 types [nodule, mass, and consolidation], presence of a cavity, and 4 axial locations) in the two groups according to the glossary of terms.14 We also analyzed the involved axial locations of the consolidation using the 4 category on the transverse CT image in the 36 patients in this study, subdivided into the interface of the fibrotic cysts (mixed-up area of honeycomb cysts, reticulation, traction bronchiectasis, and emphysema) and a normal lung; the ground-glass opacity; the midst of honeycomb cysts or reticulation; and a normal lung10 (Figure 2).


Newly detected pulmonary nontuberculous mycobacterial infection and peripheral lung cancers in patients during follow-up of idiopathic interstitial pneumonia: comparison of CT findings.

Oh SY, Kim MY, Hwang HJ, Shim TS, Choi CM, Kim SS, Kim DS - Medicine (Baltimore) (2015)

CT images showing 4 axial locations of lung cancer. The axial location of the main opacity, as seen in the transverse image, is evaluated as the association of the tumor-like lesion with fibrotic lung cysts; mixed-up area of honeycomb cysts, reticulation, traction bronchiectasis, and emphysema. The axial location is subcategorized as (A) at the interface of fibrotic cysts and a normal lung in Cancer-IIP, (B) in the midst of fibrotic cysts in NTM-IIP, (C) within ground-glass opacity in Cancer-IIP, or (D) confined in a normal lung in NTM-IIP. Cancer-IIP = newly detected lung cancer in an idiopathic interstitial pneumonia patient, NTP-IIP = newly detected pulmonary nontuberculous mycobacterial infection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554021&req=5

Figure 2: CT images showing 4 axial locations of lung cancer. The axial location of the main opacity, as seen in the transverse image, is evaluated as the association of the tumor-like lesion with fibrotic lung cysts; mixed-up area of honeycomb cysts, reticulation, traction bronchiectasis, and emphysema. The axial location is subcategorized as (A) at the interface of fibrotic cysts and a normal lung in Cancer-IIP, (B) in the midst of fibrotic cysts in NTM-IIP, (C) within ground-glass opacity in Cancer-IIP, or (D) confined in a normal lung in NTM-IIP. Cancer-IIP = newly detected lung cancer in an idiopathic interstitial pneumonia patient, NTP-IIP = newly detected pulmonary nontuberculous mycobacterial infection.
Mentions: Two chest radiologists (M.Y.K. and S.Y.O., with 18 and 4 years of experience in thoracic radiology, respectively) who were blinded to all the clinical data except those of all the IIP patients reviewed the serial 226 CT scans and determined the earliest scan that showed NTM-IIP and Cancer-IIP (113 Time1 CT; time of presentation reference to 113 Time0 CT; no main opacity). The randomly mixed 113 Time1 CT scans were independently analyzed with regard to the CT characteristics, that is, the main opacity (size, 3 types [nodule, mass, and consolidation], presence of a cavity, and 4 axial locations) in the two groups according to the glossary of terms.14 We also analyzed the involved axial locations of the consolidation using the 4 category on the transverse CT image in the 36 patients in this study, subdivided into the interface of the fibrotic cysts (mixed-up area of honeycomb cysts, reticulation, traction bronchiectasis, and emphysema) and a normal lung; the ground-glass opacity; the midst of honeycomb cysts or reticulation; and a normal lung10 (Figure 2).

Bottom Line: Consolidation (n = 30; 85.7%; odds ratio [OR], 45) and cavities (n = 14; 40%, OR, 25) were more common in NTM-IIP (all P < 0.001).The midst of the fibrotic cysts including honeycomb cysts (n = 16; 45.7%, OR, 4.95) was more common in NTM-IIP (P = 0.006).NTM-IIP appeared larger, with more frequent consolidation and cavities, and was more likely to have been located in the midst of the fibrotic cysts including honeycomb cysts at the CT, which showed that it was older than Cancer-IIP.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Radiology and Research Institute of Radiology (SYO, MYK); Department of Pulmonary and Critical Care Medicine (TSS, C-MC, DSK); Department of Oncology (C-MC), University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea; and Hallym University College of Medicine (HJH), Hallym University, Sacred Heart Hospital, Anyang, and Department of Healthcare Management (S-SK), Cheongju University, Cheongju, South Korea.

ABSTRACT
This article describes the difference between the computed tomography (CT) findings in patients with newly detected pulmonary nontuberculous mycobacterial infection (NTM-IIP) and Cancer-IIP. We retrospectively evaluated 35 NTM-IIP and 78 Cancer-IIP patients in reference to their idiopathic interstitial pneumonia CT (n = 113), using >10 years of data. Two independent radiologists analyzed the CT characteristics and the axial location of the main opacity. The interobserver agreement was good (κ > 0.771). The NTM-IIP patients were older (P = 0.034). The median size of the main opacity in the NTM-IIP (27 mm; 11-73) was larger (19 mm; 5-60; P = 0.002). Consolidation (n = 30; 85.7%; odds ratio [OR], 45) and cavities (n = 14; 40%, OR, 25) were more common in NTM-IIP (all P < 0.001). The midst of the fibrotic cysts including honeycomb cysts (n = 16; 45.7%, OR, 4.95) was more common in NTM-IIP (P = 0.006). NTM-IIP appeared larger, with more frequent consolidation and cavities, and was more likely to have been located in the midst of the fibrotic cysts including honeycomb cysts at the CT, which showed that it was older than Cancer-IIP.

Show MeSH
Related in: MedlinePlus