Nodular distribution pattern on chest computedtomography (CT) in patients diagnosed with nontuberculousmycobacteria (NTM) infections

Marušić, Ante; Kuhtić, Ivana; Mažuranić, Ivica; Janković, Mateja; Glodić, Goran; Sabol, Ivan; Stanić, Lucija (2020) Nodular distribution pattern on chest computedtomography (CT) in patients diagnosed with nontuberculousmycobacteria (NTM) infections. Wiener Klinische Wochenschrift, 133 . ISSN 0043-5325

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Abstract

Background This study evaluated the prevalence ofspreading pathways in nontuberculous mycobacteria(NTM) pulmonary infections according to nodulardistribution patterns seen on chest computed tomog-raphy (CT). Methods This study included 63 patients diagnosedwith NTM lung infections who underwent CT at ourinstitution. A retrospective analysis of CT images fo-cused on the presence and distribution of nodules, presence of intrathoracic lymphadenopathy and thepredominant side of infection in the lungs. The find-ings were classified into five groups ; centrilobular(bronchogenic spread), perilymphatic (lymphangiticspread), random (hematogenous spread), combinedpattern and no nodules present. The groups werethen compared according to other CT findings. Results Among 51 (81%) patients identified with anodular pattern on chest CT, 25 (39.8%) presentedwith centrilobular, 7 (11.1%) with perilymphatic, 6(9.5%) with random and 13 (20.6%) with combinednodular patterns but located in different areas of thelungs. The right side of the lungs was predominantin 38 cases (60.3%). Intrathoracic lymphadenopa-thy was evident in 20 patients (31.7%). Significantdifferences in distributions of nodular patterns wereseen in patients infected withMycoplasma aviumcomplex(MAC) associated with centrilobular pat-tern (p= 0.0019) andM. fortuitumassociated withrandom pattern (p= 0.0004). Some of the findingswere related to perilymphatic nodules between otherisolated species of NTM (p= 0.0379). Conclusion The results of this study showed a highproportion of perilymphatic nodules and right-sidedpredominance in the upper lobe, which, combinedwith intrathoracic lymphadenopathy is highly sugges-tive of the lymphangitic spread of lung NTM infec-tions.

Item Type:	Article
Uncontrolled Keywords:	Multidetector computed tomography ; Multiple pulmonary nodules ; Nontuberculousmycobacteria ; Lymph ; Mycobacterium tuberculosis
Subjects:	BIOMEDICINE AND HEALTHCARE > Clinical Medical Sciences BIOMEDICINE AND HEALTHCARE > Clinical Medical Sciences > Medical Microbiology BIOMEDICINE AND HEALTHCARE > Clinical Medical Sciences > Radiology
Divisions:	Division of Molecular Medicine
Depositing User:	Ivan Sabol
Date Deposited:	09 Jul 2020 10:01
URI:	http://fulir.irb.hr/id/eprint/5839
DOI:	10.1007/s00508-020-01701-1

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