Pulmonary Mycobacterium avium disease with a solitary pulmonary nodule requiring differentiation from recurrence of pulmonary adenocarcinoma.
A 56-year-old man with a past history of surgical resection of a primary pulmonary adenocarcinoma in the right upper lobe was admitted to our hospital because of a rapidly increasing solitary nodule (50x30 mm) in the right S5 followed on the chest computed tomography (CT) for three months. Although we suspected recurrence of the pulmonary adenocarcinoma and performed a CT-guided lung biopsy, we could not make a definite diagnosis. Therefore, to rule out recurrence of the primary pulmonary adenocarcinoma completely, a partial surgical resection of the right middle lobe was performed and a caseating epitheloid granuloma with acid-fast bacilli was found. As the causative pathogen, Mycobacterium avium complex (MAC) disease should be considered in the differential diagnosis of a rapidly increasing solitary nodule through this peculiar case of pulmonary MAC disease.
Kobashi
Yoshihiro
Y
Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School, Kurashiki.
Yoshida
Kouichiro
K
Miyashita
Naoyuki
N
Niki
Yoshihito
Y
Matsushima
Toshiharu
T
D000230:Adenocarcinoma / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D015269:Mycobacterium avium Complex; D015270:Mycobacterium avium-intracellulare Infection / Q000150:complications / Q000175:diagnosis*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis* / Q000382:microbiology*; D014057:Tomography, X-Ray Computed; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis*