Clinicopathologic characteristics of 34 cases non-tuberculous mycobacterial disease

doi:10.19982/j.issn.1000-6621.20240151

Abstract

Abstract:

Objective: To explore the clinicopathological characteristics of non-tuberculous mycobacterial (NTM) disease. Methods: Clinical and pathological data from 34 NTM patients who were diagnosed and treated in Peking Union Medical College Hospital between March 1, 2015 and December 31, 2023 were retrospectively collected. All patients were divided into disseminated NTM disease group (14 cases) and non-disseminated NTM disease group (20 cases). The clinicopathological characteristics of these groups were analyzed and compared. Results: Twenty-two patients (64.71%, 22/34) were infected with Mycobacterium avium/intracellular; 6 patients (17.65%, 6/34) were caused by Turtle/Mycobacterium abscessus infection, and 4 patients (11.76%, 4/34) were infected with Mycobacterium kansasii. Histopathological examination revealed granulomatous lesions in 23 cases (67.65%, 23/34). Of these, 19 cases (82.61%, 19/23) exhibited loosely arranged granuloma, 7 cases (30.43%, 7/23) showed suppurative granulomas, and basophilic necrosis was found in 5 cases (14.71%, 5/34). Pink-stained caseous necrosis was reviewed in 4 cases (11.76%, 4/34), and multinucleated giant cell reaction was observed in 18 cases (52.94%, 18/34). Positive acid-fast staining was identified in 5 out of 21 cases examined (23.81%, 5/21). Conclusion: The pathological features of NTM disease are diverse, with loosely arranged epithelioid granulomas being the most common finding. These granulomas are often accompanied by multinucleated giant cell reactions and suppurative granuloma.

Key words: Mycobacteria, atypical, Pathology, clinical, Diagnosis, differential

CLC Number:

R52
R365

Zhang Hui, Ge Li, Zhang Yuhan, Feng Ruie. Clinicopathologic characteristics of 34 cases non-tuberculous mycobacterial disease[J]. Chinese Journal of Antituberculosis, 2024, 46(7): 756-762. doi: 10.19982/j.issn.1000-6621.20240151

Figures/Tables 2

References 24

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特征	播散性NTM病组 (14例)	非播散性NTM病组 (20例)	统计检验值	P值
性别			-^e	1.000
男性	7(50.00)	9(45.00)
女性	7(50.00)	11(55.00)
年龄(岁)	49.8(41,58)	51.5(39,62)	Z=-0.263^f	0.796^e
临床症状
发热	12(85.71)	12(60.00)	-^e	0.141
咳嗽	7(50.00)	13(65.00)	-^e	0.487
自身免疫性疾病	10(71.43)	8(40.00)	-^e	0.296
抗IFN-γ抗体相关免疫缺陷病	2(14.29)	0(0.00)
系统性红斑狼疮	3(21.43)	2(10.00)
高IgE综合征	1(7.14)	0(0.00)
干燥综合征	0(0.00)	2(10.00)
类风湿关节炎	0(0.00)	2(10.00)
其他^a	4(28.57)	2(10.00)
结核病史	2(14.29)	2(10.00)	-^e	1.000
吸烟史	4(28.57)	4(20.00)	-^e	1.000
粉尘接触史	2(14.29)	4(20.00)	-^e	1.000
致病菌
鸟-胞内分枝杆菌复合群	9(64.29)	13(65.00)	-^e	1.000
龟-脓肿分枝杆菌	2(14.29)	4(20.00)	-^e	1.000
堪萨斯分枝杆菌	2(14.29)	2(10.00)	-^e	1.000
其他^b	1(7.14)	1(5.00)
病理学表现
肉芽肿	12(85.71)	11(55.00)	-^e	0.076
松散的肉芽肿	12(85.71)	6(30.00)	-^e	0.002
结核病样肉芽肿	0(0.00)	4(20.00)	-^e	0.126
化脓性肉芽肿	4(28.57)	3(15.00)	-^e	0.410
多核巨细胞	9(64.29)	9(45.00)	-^e	0.315
坏死	6(42.86)	4(20.00)	-^e	0.252
干酪样坏死	2(14.29)	2(10.00)	-^e	1.000
嗜碱性坏死	4(28.57)	1(5.00)	-^e	0.135
化脓性坏死	4(28.57)	1(5.00)	-^e	0.135
抗酸染色阳性	2(18.18)^c	3(30.00)^d	-^e	0.361