Dry pleurisy complicating solitary pulmonary nodules caused by Mycobacterium avium: A case report

Takanori Asakura, Makoto Ishii, Mizuha Haraguchi, Ikuo Kamiyama, Mitsutomo Kohno, Hiroyuki Sakamaki, Katsura Emoto, Yuichiro Hayashi, Hiroaki Sugiura, Ichiro Kawada, Kenzo Soejima, Ho Namkoong, Sadatomo Tasaka, Naoki Hasegawa, Tomoko Betsuyaku

研究成果: Article

4 引用 (Scopus)

抄録

Introduction: Mycobacterium avium complex (MAC) lung disease presenting as a solitary pulmonary nodule (MAC-SPN) is often asymptomatic, is more common in middle to old age, and mimics lung cancer or tuberculoma. We report herein a case of MAC-SPN in an immunocompetent young adult patient, presenting with persistent chest pain and a subacutely progressive nodule with high intense 18F-fluorodeoxyglucose uptake. Histological examination of resected specimens revealed pleurisy, which is a rare finding of MAC-SPN. Case presentation: A 36-year-old Japanese male presented with chest pain and a subacutely progressive pulmonary nodule. Positron emission tomography-computed tomography showed high intense 18F-fluorodeoxyglucose uptake in the nodule. Owing to his continuous chest pain and subacutely progressive nodules, wedge resection was performed using video-assisted thoracoscopic surgery. Histological examination revealed an epithelioid granuloma and pleurisy, and the lung tissue culture was positive for mycobacteria identified as M. avium. Conclusion: This is the first report of MAC-SPN occurring with persistent chest pain, suggesting that MAC should be considered in the differential diagnosis of a solitary pulmonary nodule, even for patients who experience persistent chest pain. As in the present case, surgical resection with video-assisted thoracoscopic surgery is a reasonable approach to the diagnosis and treatment of MAC-SPN with possible malignancy, especially as MAC can be diagnosed using resected lung tissue culture with histological confirmation.

元の言語English
ジャーナルJournal of Medical Case Reports
DOI
出版物ステータスAccepted/In press - 2015 10 26

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Solitary Pulmonary Nodule
Mycobacterium avium
Mycobacterium avium Complex
Pleurisy
Chest Pain
Video-Assisted Thoracic Surgery
Fluorodeoxyglucose F18
Lung
Tuberculoma
Mycobacterium
Granuloma
Lung Diseases
Young Adult
Lung Neoplasms
Differential Diagnosis

ASJC Scopus subject areas

  • Medicine(all)

これを引用

Dry pleurisy complicating solitary pulmonary nodules caused by Mycobacterium avium : A case report. / Asakura, Takanori; Ishii, Makoto; Haraguchi, Mizuha; Kamiyama, Ikuo; Kohno, Mitsutomo; Sakamaki, Hiroyuki; Emoto, Katsura; Hayashi, Yuichiro; Sugiura, Hiroaki; Kawada, Ichiro; Soejima, Kenzo; Namkoong, Ho; Tasaka, Sadatomo; Hasegawa, Naoki; Betsuyaku, Tomoko.

:: Journal of Medical Case Reports, 26.10.2015.

研究成果: Article

Asakura, Takanori ; Ishii, Makoto ; Haraguchi, Mizuha ; Kamiyama, Ikuo ; Kohno, Mitsutomo ; Sakamaki, Hiroyuki ; Emoto, Katsura ; Hayashi, Yuichiro ; Sugiura, Hiroaki ; Kawada, Ichiro ; Soejima, Kenzo ; Namkoong, Ho ; Tasaka, Sadatomo ; Hasegawa, Naoki ; Betsuyaku, Tomoko. / Dry pleurisy complicating solitary pulmonary nodules caused by Mycobacterium avium : A case report. :: Journal of Medical Case Reports. 2015.
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title = "Dry pleurisy complicating solitary pulmonary nodules caused by Mycobacterium avium: A case report",
abstract = "Introduction: Mycobacterium avium complex (MAC) lung disease presenting as a solitary pulmonary nodule (MAC-SPN) is often asymptomatic, is more common in middle to old age, and mimics lung cancer or tuberculoma. We report herein a case of MAC-SPN in an immunocompetent young adult patient, presenting with persistent chest pain and a subacutely progressive nodule with high intense 18F-fluorodeoxyglucose uptake. Histological examination of resected specimens revealed pleurisy, which is a rare finding of MAC-SPN. Case presentation: A 36-year-old Japanese male presented with chest pain and a subacutely progressive pulmonary nodule. Positron emission tomography-computed tomography showed high intense 18F-fluorodeoxyglucose uptake in the nodule. Owing to his continuous chest pain and subacutely progressive nodules, wedge resection was performed using video-assisted thoracoscopic surgery. Histological examination revealed an epithelioid granuloma and pleurisy, and the lung tissue culture was positive for mycobacteria identified as M. avium. Conclusion: This is the first report of MAC-SPN occurring with persistent chest pain, suggesting that MAC should be considered in the differential diagnosis of a solitary pulmonary nodule, even for patients who experience persistent chest pain. As in the present case, surgical resection with video-assisted thoracoscopic surgery is a reasonable approach to the diagnosis and treatment of MAC-SPN with possible malignancy, especially as MAC can be diagnosed using resected lung tissue culture with histological confirmation.",
keywords = "F-fluorodeoxyglucose, Mycobacterium avium complex lung disease, positron emission tomography, solitary pulmonary nodule",
author = "Takanori Asakura and Makoto Ishii and Mizuha Haraguchi and Ikuo Kamiyama and Mitsutomo Kohno and Hiroyuki Sakamaki and Katsura Emoto and Yuichiro Hayashi and Hiroaki Sugiura and Ichiro Kawada and Kenzo Soejima and Ho Namkoong and Sadatomo Tasaka and Naoki Hasegawa and Tomoko Betsuyaku",
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T1 - Dry pleurisy complicating solitary pulmonary nodules caused by Mycobacterium avium

T2 - A case report

AU - Asakura, Takanori

AU - Ishii, Makoto

AU - Haraguchi, Mizuha

AU - Kamiyama, Ikuo

AU - Kohno, Mitsutomo

AU - Sakamaki, Hiroyuki

AU - Emoto, Katsura

AU - Hayashi, Yuichiro

AU - Sugiura, Hiroaki

AU - Kawada, Ichiro

AU - Soejima, Kenzo

AU - Namkoong, Ho

AU - Tasaka, Sadatomo

AU - Hasegawa, Naoki

AU - Betsuyaku, Tomoko

PY - 2015/10/26

Y1 - 2015/10/26

N2 - Introduction: Mycobacterium avium complex (MAC) lung disease presenting as a solitary pulmonary nodule (MAC-SPN) is often asymptomatic, is more common in middle to old age, and mimics lung cancer or tuberculoma. We report herein a case of MAC-SPN in an immunocompetent young adult patient, presenting with persistent chest pain and a subacutely progressive nodule with high intense 18F-fluorodeoxyglucose uptake. Histological examination of resected specimens revealed pleurisy, which is a rare finding of MAC-SPN. Case presentation: A 36-year-old Japanese male presented with chest pain and a subacutely progressive pulmonary nodule. Positron emission tomography-computed tomography showed high intense 18F-fluorodeoxyglucose uptake in the nodule. Owing to his continuous chest pain and subacutely progressive nodules, wedge resection was performed using video-assisted thoracoscopic surgery. Histological examination revealed an epithelioid granuloma and pleurisy, and the lung tissue culture was positive for mycobacteria identified as M. avium. Conclusion: This is the first report of MAC-SPN occurring with persistent chest pain, suggesting that MAC should be considered in the differential diagnosis of a solitary pulmonary nodule, even for patients who experience persistent chest pain. As in the present case, surgical resection with video-assisted thoracoscopic surgery is a reasonable approach to the diagnosis and treatment of MAC-SPN with possible malignancy, especially as MAC can be diagnosed using resected lung tissue culture with histological confirmation.

AB - Introduction: Mycobacterium avium complex (MAC) lung disease presenting as a solitary pulmonary nodule (MAC-SPN) is often asymptomatic, is more common in middle to old age, and mimics lung cancer or tuberculoma. We report herein a case of MAC-SPN in an immunocompetent young adult patient, presenting with persistent chest pain and a subacutely progressive nodule with high intense 18F-fluorodeoxyglucose uptake. Histological examination of resected specimens revealed pleurisy, which is a rare finding of MAC-SPN. Case presentation: A 36-year-old Japanese male presented with chest pain and a subacutely progressive pulmonary nodule. Positron emission tomography-computed tomography showed high intense 18F-fluorodeoxyglucose uptake in the nodule. Owing to his continuous chest pain and subacutely progressive nodules, wedge resection was performed using video-assisted thoracoscopic surgery. Histological examination revealed an epithelioid granuloma and pleurisy, and the lung tissue culture was positive for mycobacteria identified as M. avium. Conclusion: This is the first report of MAC-SPN occurring with persistent chest pain, suggesting that MAC should be considered in the differential diagnosis of a solitary pulmonary nodule, even for patients who experience persistent chest pain. As in the present case, surgical resection with video-assisted thoracoscopic surgery is a reasonable approach to the diagnosis and treatment of MAC-SPN with possible malignancy, especially as MAC can be diagnosed using resected lung tissue culture with histological confirmation.

KW - F-fluorodeoxyglucose

KW - Mycobacterium avium complex lung disease

KW - positron emission tomography

KW - solitary pulmonary nodule

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U2 - 10.1186/s13256-015-0723-4

DO - 10.1186/s13256-015-0723-4

M3 - Article

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JO - Journal of Medical Case Reports

JF - Journal of Medical Case Reports

SN - 1752-1947

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