Endobronchial carcinoid tumor combined with pulmonary non-tuberculous mycobacterial infection: report of two cases.
We report here two cases of endobronchial carcinoid tumor complicated with pulmonary infection with non-tuberculous mycobacteria (NTM). Case 1 was an 81-year-old woman with the left lower lobe atelectasis. Bronchoscopy showed complete obstruction of the left basal bronchus by a tumor and a sleeve lower lobectomy with mediastinal lymph node dissection was performed. Pathological examination showed typical carcinoid located in the left basal bronchus and many caseous granulomas containing mycobacteria in the lung parenchyma distal to the bronchus. Bacterial examinations of sputum and gastric juice after the operation showed a growth of Mycobacterium kansasii. Case 2 was a 50-year-old woman with the atelectasis of the left upper division. Bronchoscopy showed complete obstruction of the left upper division bronchus by a tumor and a left upper lobectomy with mediastinal lymph node dissection was performed. Pathological examination showed typical carcinoid located in the left upper division bronchus and many caseous granulomas in the lung parenchyma distal to the bronchus. The Ziehl-Neelsen stain showed many mycobacteria in these granulomas and they were identified as Mycobacterium avium by PCR analysis. Although NTM are not well recognized as possible pathogens of pulmonary infection related to bronchial obstruction by endobronchial carcinoma, our experiences rouse a caution to consider NTM as potential pathogens. We also discuss the possible mechanisms responsible for the specific relationship between carcinoid tumor and TNM.
Nakamura
Yoshihiro
Y
Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aoba-ku, Sendai 980-8575, Japan.
Okada
Yoshinori
Y
Endo
Chiaki
C
Aikawa
Hirokazu
H
Sakurada
Akira
A
Sato
Masami
M
Kondo
Takashi
T
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents; D001984:Bronchial Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D001999:Bronchoscopy; D002276:Carcinoid Tumor / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D005750:Gastric Juice / Q000382:microbiology; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008875:Middle Aged; D015269:Mycobacterium avium Complex / Q000302:isolation & purification*; D015270:Mycobacterium avium-intracellulare Infection / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D019909:Mycobacterium kansasii / Q000302:isolation & purification*; D018410:Pneumonia, Bacterial / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D013183:Sputum / Q000382:microbiology
D000900:Anti-Bacterial Agents