J Korean Med Sci.  2009 Jun;24(3):427-432. 10.3346/jkms.2009.24.3.427.

Comparison of Clinical and Radiographic Characteristics between Nodular Bronchiectatic Form of Nontuberculous Mycobacterial Lung Disease and Diffuse Panbronchiolitis

• Park HY
• Suh GY
• Chung MP
• Kim H
• Kwon OJ
• Chung MJ
• Kim TS
• Lee KS
• Koh WJ

• KMID: 1779158
• DOI: http://doi.org/10.3346/jkms.2009.24.3.427

Abstract

The nodular bronchiectatic form of nontuberculous mycobacterial (NTM) lung disease and diffuse panbronchiolits (DPB) show similar clinical and radiographic findings. The present study was performed to clarify the clinicoradiographic similarities as well as the differences between NTM lung disease and DPB. The initial clinicoradiographic features of 78 patients with the nodular bronchiectatic form of NTM lung disease (41 patients with Mycobacterium avium complex infection and 37 patients with Mycobacterium abscessus infection) were compared with those of 35 patients with DPB. Old age, female sex, a history of tuberculosis treatment, and hemoptysis were related to NTM lung disease while exertional dyspnea, coarse crackles, history of sinusitis, obstructive abnormalities in pulmonary function tests, and hypoxemia were related to DPB. The number of lobes involved with bronchiolitis and bronchiectasis on chest computed tomography were more numerous in DPB patients. There is considerable overlap in the clinical and radiographic appearances of the nodular bronchiectatic form of NTM lung disease and DPB, although some clinicoradiographic features differ between two diseases. The correct diagnosis, including aggressive microbiologic evaluation, should be made for the appropriate management of patients presenting with bilateral bronchiectasis and bronchiolitis.

Keyword

Nontuberculous Mycobacteria; Bronchiectasis; Bronchiolitis; Mycobacterium Avium Complex

MeSH Terms

Adult
Age Factors
Aged
Bronchiectasis/*diagnosis/radiography
Bronchiolitis/*diagnosis/radiography
Diagnosis, Differential
Female
Humans
Lung Diseases/*diagnosis/microbiology/radiography
Male
Middle Aged
Mycobacterium Infections/*diagnosis/radiography
Mycobacterium avium Complex
Mycobacterium avium-intracellulare Infection/diagnosis/radiography
Respiratory Function Tests
Sex Factors
Tomography, X-Ray Computed
Tuberculosis, Pulmonary/therapy

Figure

• 

  Fig. 1 Typical radiographic presentations of the nodular bronchiectatic form of nontuberculous mycobacterial lung disease and diffuse panbronchiolitis. (A) A 57-yr-old woman with Mycobacterium avium lung disease. Axial image of chest CT shows tubular bronchiectasis associated with lung volume loss in both right middle lobe and lingular division of the left upper lobe. Also note clustered centilobular micronodules and branching linear opacities (tree-in-bud pattern) in the right lower lobe (arrows). (B) A 23-yr-old woman with diffuse panbrochiolitis. Axial image of c hest CT shows innumerable centrilobular micronodules and branching linear opacities or bronchioloectasis in entire lung. Also note bronchiectasis in both right middle lobe and lingular division of the left upper lobe (arrows).

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