Dry pleurisy complicating solitary pulmonary nodules caused by Mycobacterium avium: a case report. (December 2015)

• Record Type: Journal Article
• Authors: Asakura, Takanori; Ishii, Makoto; Haraguchi, Mizuha; Kamiyama, Ikuo; Kohno, Mitsutomo; Sakamaki, Hiroyuki; Emoto, Katsura; Hayashi, Yuichiro; Sugiura, Hiroaki; Kawada, Ichiro; Soejima, Kenzo; Namkoong, Ho; Tasaka, Sadatomo; Hasegawa, Naoki; Betsuyaku, Tomoko
• Is Part Of: Journal of medical case reports. Volume 9:Number 1(2015)
• Page Start: 1
• Page End: 4
• Publication Date: 2015-12
• Subjects: Mycobacterium avium complex lung disease -- solitary pulmonary nodule -- 18F-fluorodeoxyglucose -- positron emission tomography; Medicine -- Research -- Periodicals; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1186/s13256-015-0723-4
• Languages: English
• ISSNs: 1752-1947

Abstract

Abstract Introduction Mycobacterium avium complex (MAC) lung disease presenting as a solitary pulmonary nodule (MAC-SPN) is often asymptomatic, is more common in middle to old age, and mimics lung cancer or tuberculoma. We report herein a case of MAC-SPN in an immunocompetent young adult patient, presenting with persistent chest pain and a subacutely progressive nodule with high intense18 F-fluorodeoxyglucose uptake. Histological examination of resected specimens revealed pleurisy, which is a rare finding of MAC-SPN. Case presentation A 36-year-old Japanese male presented with chest pain and a subacutely progressive pulmonary nodule. Positron emission tomography-computed tomography showed high intense18 F-fluorodeoxyglucose uptake in the nodule. Owing to his continuous chest pain and subacutely progressive nodules, wedge resection was performed using video-assisted thoracoscopic surgery. Histological examination revealed an epithelioid granuloma and pleurisy, and the lung tissue culture was positive for mycobacteria identified asM. avium . Conclusion This is the first report of MAC-SPN occurring with persistent chest pain, suggesting that MAC should be considered in the differential diagnosis of a solitary pulmonary nodule, even for patients who experience persistent chest pain. As in the present case, surgical resection with video-assisted thoracoscopic surgery is a reasonable approach to the diagnosis and treatment of MAC-SPN with possible malignancy, especially as MAC can be diagnosed using resected lung tissue culture with histological confirmation.