title: Pulmonary Mycobacterium intracellulare disease with a solitary pulmonary nodule detected at the onset of pneumothorax.
abstract: A 61-year-old man with a past history of pulmonary emphysema 6 years earlier was admitted to the emergency department at our hospital because of cough and dyspnea. Left pneumothorax was recognized on a chest radiograph. After his admission to the emergency department, chest drainage was inserted and the left lung was expanded. Afterwards, a nodular shadow (>1.5 cm) was found in the left upper lobe, and differentiation from pulmonary adenocarcinoma was required. As a definite diagnosis could not be made by bronchoscopy, video-assisted thoracoscopic surgery was performed, and a solitary nodule in the left upper lobe was resected. Histologically, a caseating epitheloid granuloma with acid-fast bacilli was found. Regarding the causative pathogen, Mycobacterium intracellulare was identified from the surgically resected specimen. We have reported a peculiar case of pulmonary M. intracellulare disease, detected at the onset of left secondary pneumothorax caused by pulmonary emphysema, which required differentiation from pulmonary adenocarcinoma.
authors.affiliation: Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan. yoshihiro@med.kawasaki-m.ac.jp
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kobashi
authors.forename: Minoru
authors.initials: M
authors.lastname: Fukuda
authors.forename: Kouichiro
authors.initials: K
authors.lastname: Yoshida
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Miyashita
authors.forename: Mikio
authors.initials: M
authors.lastname: Oka
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis; D003937:Diagnosis, Differential; D006801:Humans; D008168:Lung / Q000473:pathology; D008171:Lung Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008175:Lung Neoplasms / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D015269:Mycobacterium avium Complex / Q000302:isolation & purification; D015270:Mycobacterium avium-intracellulare Infection / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D011030:Pneumothorax / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed