title: Pulmonary mycobacterial spindle cell pseudotumor in a lung transplant patient: progression without therapy and response to therapy.
abstract: Mycobacterial spindle cell pseudotumor (MSP) represents a rare, non-malignant, mass-forming reaction to various mycobacterial infections, typically occurring in immunocompromised patients. It is characterized by the proliferation of spindle-shaped fibrohistiocytic cells without the formation of epithelioid granulomas. Without staining for acid-fast bacilli, histological distinction from other spindle cell lesions, including malignancy, can be difficult. Most of the MSP cases reported in the literature have involved lymph nodes, skin, spleen, or bone marrow, but rarely involve the lung. MSP predominately occurs in patients who are immunosuppressed. We present a patient with MSP of the transplanted lung caused by non-tuberculous mycobacteria, in whom both the natural course of the untreated pseudotumor as well as the response to antimycobacterial treatments were observed.
authors.affiliation: Division of Infectious Diseases and International Medicine, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA.
authors.forename: M
authors.initials: M
authors.lastname: Franco
authors.affiliation: Division of Infectious Diseases, University of Maryland School of Medicine, Baltimore, Maryland, USA.
authors.forename: A
authors.initials: A
authors.lastname: Amoroso
authors.affiliation: Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
authors.forename: A P
authors.initials: AP
authors.lastname: Burke
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.
authors.forename: E J
authors.initials: EJ
authors.lastname: Britt
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.
authors.forename: R M
authors.identifier: http://orcid.org/0000-0002-4681-7070
authors.initials: RM
authors.lastname: Reed
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017963:Azithromycin / Q000008:administration & dosage; D018450:Disease Progression; D004977:Ethambutol / Q000008:administration & dosage; D005260:Female; D024841:Fluoroquinolones / Q000008:administration & dosage; D006801:Humans; D016867:Immunocompromised Host; D008168:Lung / Q000000981:diagnostic imaging / Q000601:surgery; D016040:Lung Transplantation; D000077266:Moxifloxacin; D015269:Mycobacterium avium Complex / Q000302:isolation & purification*; D015270:Mycobacterium avium-intracellulare Infection / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D017963:Azithromycin; D004977:Ethambutol; D000077266:Moxifloxacin
keywords: Mycobacterium avium complex; lung transplant; mycobacterial spindle cell pseudotumor; non-tuberculous mycobacteria