Limits...
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.

Show MeSH

Related in: MedlinePlus

A 57-year-old male patient with biopsy-proven, usual interstitial pneumonia and incidental lung cancer. (A) The initial, , high-resolution CT transverse image lung window (1-mm reconstruction) at the level of the right inferior pulmonary vein shows no significant main opacity. There are diffuse reticulation, ground-glass opacity, and air cysts with subpleural dominancy showing a UIP pattern. (B) Sixteen months later, the first follow-up, high-resolution CT transverse image lung window (1-mm reconstruction) shows a newly appearing, irregular margined nodule at the interface of fibrotic cysts compared to that seen on  CT (A) in the right lower lobe. (C) Six months later, the follow-up, conventional CT transverse image lung window (5-mm reconstruction) shows the increased size of the nodule at the same axial location. (D) The transverse location of the nodule was seen as the “interface” on the gross pathology examination performed following wedge resection. The nodule revealed adenocarcinoma. (E) Seven months later, the follow-up, high-resolution CT transverse image lung window (1-mm reconstruction) shows a new, well-defined nodule at the wedge resection site of the right lower lobe revealing “stump recurrence.” Another new nodule in the left lower lobe in the interface revealed “de novo lung cancer” with a different cell type of adenocarcinoma.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4554021&req=5

Figure 5: A 57-year-old male patient with biopsy-proven, usual interstitial pneumonia and incidental lung cancer. (A) The initial, , high-resolution CT transverse image lung window (1-mm reconstruction) at the level of the right inferior pulmonary vein shows no significant main opacity. There are diffuse reticulation, ground-glass opacity, and air cysts with subpleural dominancy showing a UIP pattern. (B) Sixteen months later, the first follow-up, high-resolution CT transverse image lung window (1-mm reconstruction) shows a newly appearing, irregular margined nodule at the interface of fibrotic cysts compared to that seen on CT (A) in the right lower lobe. (C) Six months later, the follow-up, conventional CT transverse image lung window (5-mm reconstruction) shows the increased size of the nodule at the same axial location. (D) The transverse location of the nodule was seen as the “interface” on the gross pathology examination performed following wedge resection. The nodule revealed adenocarcinoma. (E) Seven months later, the follow-up, high-resolution CT transverse image lung window (1-mm reconstruction) shows a new, well-defined nodule at the wedge resection site of the right lower lobe revealing “stump recurrence.” Another new nodule in the left lower lobe in the interface revealed “de novo lung cancer” with a different cell type of adenocarcinoma.

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 57-year-old male patient with biopsy-proven, usual interstitial pneumonia and incidental lung cancer. (A) The initial, , high-resolution CT transverse image lung window (1-mm reconstruction) at the level of the right inferior pulmonary vein shows no significant main opacity. There are diffuse reticulation, ground-glass opacity, and air cysts with subpleural dominancy showing a UIP pattern. (B) Sixteen months later, the first follow-up, high-resolution CT transverse image lung window (1-mm reconstruction) shows a newly appearing, irregular margined nodule at the interface of fibrotic cysts compared to that seen on  CT (A) in the right lower lobe. (C) Six months later, the follow-up, conventional CT transverse image lung window (5-mm reconstruction) shows the increased size of the nodule at the same axial location. (D) The transverse location of the nodule was seen as the “interface” on the gross pathology examination performed following wedge resection. The nodule revealed adenocarcinoma. (E) Seven months later, the follow-up, high-resolution CT transverse image lung window (1-mm reconstruction) shows a new, well-defined nodule at the wedge resection site of the right lower lobe revealing “stump recurrence.” Another new nodule in the left lower lobe in the interface revealed “de novo lung cancer” with a different cell type of adenocarcinoma.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 5: A 57-year-old male patient with biopsy-proven, usual interstitial pneumonia and incidental lung cancer. (A) The initial, , high-resolution CT transverse image lung window (1-mm reconstruction) at the level of the right inferior pulmonary vein shows no significant main opacity. There are diffuse reticulation, ground-glass opacity, and air cysts with subpleural dominancy showing a UIP pattern. (B) Sixteen months later, the first follow-up, high-resolution CT transverse image lung window (1-mm reconstruction) shows a newly appearing, irregular margined nodule at the interface of fibrotic cysts compared to that seen on CT (A) in the right lower lobe. (C) Six months later, the follow-up, conventional CT transverse image lung window (5-mm reconstruction) shows the increased size of the nodule at the same axial location. (D) The transverse location of the nodule was seen as the “interface” on the gross pathology examination performed following wedge resection. The nodule revealed adenocarcinoma. (E) Seven months later, the follow-up, high-resolution CT transverse image lung window (1-mm reconstruction) shows a new, well-defined nodule at the wedge resection site of the right lower lobe revealing “stump recurrence.” Another new nodule in the left lower lobe in the interface revealed “de novo lung cancer” with a different cell type of adenocarcinoma.
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