J Korean Med Sci.  2005 Oct;20(5):777-783. 10.3346/jkms.2005.20.5.777.

Thin-Section CT Findings of Nontuberculous Mycobacterial Pulmonary Diseases: Comparison Between Mycobacterium avium-intracellulare Complex and Mycobacterium abscessus Infection

• Chung MJ
• Lee KS
• Koh WJ
• Lee JH
• Kim TS
• Kwon OJ
• Kim S

• KMID: 1781760
• DOI: http://doi.org/10.3346/jkms.2005.20.5.777

Abstract

We aimed to compare the CT findings of nontuberculous mycobacterial pulmonary diseases caused by Mycobacterium avium-intracellulare complex (MAC) and Mycobacterium abscessus. Two chest radiologists analyzed retrospectively the thin-section CT findings of 51 patients with MAC and 36 with M. abscessus infection in terms of patterns and forms of lung lesions. No significant difference was found between MAC and M. abscessus infection in the presence of small nodules, tree-in-bud pattern, and bronchiectasis. However, lobar volume decrease (p=0.001), nodule (p=0.018), airspace consolidation (p=0.047) and thin-walled cavity (p=0.009) were more frequently observed in MAC infection. The upper lobe cavitary form was more frequent in the MAC (19 of 51 patients, 37%) group than M. abscessus (5 of 36, 14%) (p=0.029), whereas the nodular bronchiectatic form was more frequent in the M. abscessus group ([29 of 36, 81%] vs. [27 of 51, 53%] in MAC) (p=0.012). In conclusion, there is considerable overlap in common CT findings of MAC and M. abscessus pulmonary infection; however, lobar volume loss, nodule, airspace consolidation, and thin-walled cavity are more frequently seen in MAC than M. abscessus infection.

Keyword

Mycobacteria, Atypical; Bronchiectasis; Bronchiolitis; Tomograph, X-ray Computed; CT, thinsection; Mycobacterium avium; Mycobacterium abscessus; Tuberculosis

MeSH Terms

Adult
Aged
Aged, 80 and over
Anatomy, Cross-Sectional/methods
Diagnosis, Differential
Female
Humans
Lung Diseases/*microbiology/*radiography
Male
Middle Aged
Mycobacterium Infections, Atypical/microbiology/radiography
Mycobacterium avium-intracellulare Infection/microbiology/*radiography
Research Support, Non-U.S. Gov't
Retrospective Studies
Tomography, Spiral Computed/*methods
Tuberculosis, Pulmonary/radiography

Figure

• 

  Fig. 1 A 66-yr-old man with M. avium-intracellulare complex pulmonary disease. (A) Transaxial thin-section (2.5-mm thickness) CT scan obtained at level of great vessels shows multiple large thin-walled cavities in both lung apices. Also note several small nodules (arrows) in right lung. (B) CT (2.5-mm thickness) scan obtained at level of suprahepatic inferior vena cava shows multiple small nodules and branching centrilobular nodules, so-called tree-in-bud pattern (arrows), in lingular segment of left upper lobe and left lower lobe. Small nodule (arrowhead) is also seen in right middle lobe.

• 

  Fig. 2 A 45-yr-old woman with M. abscessus pulmonary disease. (A) Transaxial thin-section (2.5-mm thickness) CT scan obtained at level of proximal lower lobar bronchus shows bronchiectasis (arrows) and multiple small nodules and branching centrilobular nodules, so-called tree-in-bud pattern (arrowheads) in right lung. (B) CT (2.5-mm thickness) scan obtained at level of basal trunk shows bronchiectasis (arrows) and multiple small nodules and branching centrilobular nodules, so-called tree-in-bud pattern (arrowheads) in both lungs.

• 

  Fig. 3 A 52-yr-old woman with M. avium-intracellulare complex pulmonary infection. (A) Transaxial thin-section (2.5-mm thickness) CT scan obtained at level of great vessels shows subsegmental consolidation with open bronchus sign in right upper lobe (arrows). (B) CT (2.5-mm thickness) scan obtained at level of right upper lobar bronchus shows airspace consolidation with surrounding ground-glass opacity (arrows) along bronchovascular bundles in anterior segments of both upper lobes. Also note small nodules in right upper lobe. (C), CT (2.5-mm thickness) scan obtained at lung base shows lobular consolidation in left lower lobe (arrows). Also note lesion of tree-in-bud pattern (arrowhead) in left lower lobe and small nodules in right middle lobe.

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  Fig. 4 A 69-yr-old woman with M. avium-intracellulare complex pulmonary disease. Transaxial thin-section (2.5-mm thickness) CT scan obtained at level of bronchus intermedius shows multiple cavitary nodules (arrowheads) in both lungs. Also note small nodules (arrows) and bronchiectasis (white arrows).

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