Tuberc Respir Dis.  2013 Jan;74(1):28-31.

A Case of Congenital Cystic Adenomatoid Malformation Infected with Mycobacterium avium-intracellulare Complex

• Kim YJ
• Kim DY
• Seo JW
• Lee SA
• Hwang JJ
• Kim HJ
• Lee KY

Abstract

We present a case of congenital cystic adenomatoid malformation (CCAM) in a 25-year-old male who was presented with chronic cough. Chest radiography revealed an abnormal mass-like shadow in the right lower pulmonary zone. A contrast enhanced computed tomography showed an 11 cm solid, cystic mixed mass on the right lower lobe. A right lower lobectomy was performed by video-assisted thoracoscopic surgery without complications. The gross specimen showed a massive cavitation with multiloculated cysts of varying size, consistent with CCAM, along with noticeable granulomatous inflammation. Non-tuberculosis mycobacteria were isolated from a bronchial wash specimen, and the resected tissue homogenates were positive for Mycobacterium avium-intracellulare complex by polymerase chain reaction.

Keyword

Cystic Adenomatoid Malformation of Lung, Congenital; Nontuberculous Mycobacteria; Mycobacterium avium Complex

MeSH Terms

Cough
Cystic Adenomatoid Malformation of Lung, Congenital
Humans
Inflammation
Male
Mycobacterium
Mycobacterium avium Complex
Nontuberculous Mycobacteria
Polymerase Chain Reaction
Thoracic Surgery, Video-Assisted
Thorax

Figure

• 

  Figure 1 (A) A chest radiograph showing increased haziness in the right lower lobe. (B) A thoracic computed tomography scan performed at the same time showing an 11 cm solid, cystic mixed mass in the right lower lobe without feeding vessels from the descending aorta.

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  Figure 2 A cutting plane of the resected lung specimen shows massive cavitation with multiloculated cysts of varying size within the lesion.

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  Figure 3 (A) The lesion consists of multiple cysts with caseous granulomas and inflamed granulation tissue (H&E stain, ×40). (B) The cysts are lined by cuboidal-to-ciliated pseudostratified columnar epithelium (H&E stain, ×100). (C) A marked caseous granuloma is shown, and the necrotic center is surrounded by epithelioid histiocytes (H&E stain, ×100). (D) Electrophoresis of the polymerase chain reaction product. M: size marker; PC 1: positive control (Kit-positive sample); PC 2: positive control (Mycobacterium avium-intracellulare complex); NC: negative control; Pt: patient sample.

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