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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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A 61-year-old man with usual interstitial pneumonia (UIP) proven by the clinical–radiological diagnosis as well as an incidental pulmonary nontuberculous mycobacterial infection detected during the UIP follow-up. (A) The initial, , high-resolution CT transverse image lung window (1-mm reconstruction) at the basal segmental pulmonary artery level shows no significant main opacity. There are diffuse reticulation, ground-glass opacity, and air cysts with subpleural dominancy, all of which show a UIP pattern. (B) At the time of the follow-up 10 months later, a CT transverse image in the lung window (1-mm reconstruction) obtained following steroid therapy and at the same level, shows newly appearing, unusually shaped consolidation with a thick irregular cavity in the midst of fibrotic cysts compared to that seen on the  CT image (A). CT = computed tomography.
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Figure 4: A 61-year-old man with usual interstitial pneumonia (UIP) proven by the clinical–radiological diagnosis as well as an incidental pulmonary nontuberculous mycobacterial infection detected during the UIP follow-up. (A) The initial, , high-resolution CT transverse image lung window (1-mm reconstruction) at the basal segmental pulmonary artery level shows no significant main opacity. There are diffuse reticulation, ground-glass opacity, and air cysts with subpleural dominancy, all of which show a UIP pattern. (B) At the time of the follow-up 10 months later, a CT transverse image in the lung window (1-mm reconstruction) obtained following steroid therapy and at the same level, shows newly appearing, unusually shaped consolidation with a thick irregular cavity in the midst of fibrotic cysts compared to that seen on the CT image (A). CT = computed tomography.

Mentions: In the axial location, the midst of fibrotic cysts (n = 16; 45.7%; and OR, 4.95) (Figure 3) and a normal lung (n = 13; 37.1%; and OR, 4.42) were more common in the NTM-IIP patients than in the Cancer-IIP patients (P = 0.006 and 0.013, respectively) (Figures 4 and 5, and Table 2). Lung cancer was mainly manifested at the interface (n = 34, 43.6%), and then at the midst of the fibrotic cysts (n = 22, 28.2%).


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)

A 61-year-old man with usual interstitial pneumonia (UIP) proven by the clinical–radiological diagnosis as well as an incidental pulmonary nontuberculous mycobacterial infection detected during the UIP follow-up. (A) The initial, , high-resolution CT transverse image lung window (1-mm reconstruction) at the basal segmental pulmonary artery level shows no significant main opacity. There are diffuse reticulation, ground-glass opacity, and air cysts with subpleural dominancy, all of which show a UIP pattern. (B) At the time of the follow-up 10 months later, a CT transverse image in the lung window (1-mm reconstruction) obtained following steroid therapy and at the same level, shows newly appearing, unusually shaped consolidation with a thick irregular cavity in the midst of fibrotic cysts compared to that seen on the  CT image (A). CT = computed tomography.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 4: A 61-year-old man with usual interstitial pneumonia (UIP) proven by the clinical–radiological diagnosis as well as an incidental pulmonary nontuberculous mycobacterial infection detected during the UIP follow-up. (A) The initial, , high-resolution CT transverse image lung window (1-mm reconstruction) at the basal segmental pulmonary artery level shows no significant main opacity. There are diffuse reticulation, ground-glass opacity, and air cysts with subpleural dominancy, all of which show a UIP pattern. (B) At the time of the follow-up 10 months later, a CT transverse image in the lung window (1-mm reconstruction) obtained following steroid therapy and at the same level, shows newly appearing, unusually shaped consolidation with a thick irregular cavity in the midst of fibrotic cysts compared to that seen on the CT image (A). CT = computed tomography.
Mentions: In the axial location, the midst of fibrotic cysts (n = 16; 45.7%; and OR, 4.95) (Figure 3) and a normal lung (n = 13; 37.1%; and OR, 4.42) were more common in the NTM-IIP patients than in the Cancer-IIP patients (P = 0.006 and 0.013, respectively) (Figures 4 and 5, and Table 2). Lung cancer was mainly manifested at the interface (n = 34, 43.6%), and then at the midst of the fibrotic cysts (n = 22, 28.2%).

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