Abstract
BackgroundPatients with COPD are at risk of non-tuberculous mycobacterial infection (NTM). This study examined the histology of lung tissue from COPD patients following lung volume reduction with particular focus on evidence of mycobacterial infection.MethodsRetrospective histological study of 142 consecutive lung volume reduction surgical specimens (126 separate patients) at Royal Brompton Hospital between 2000 – 2013, with prospectively collected preoperative data on exacerbation rate, lung function and body mass index.Results92% of patients had at least one other histological diagnosis in addition to emphysema. 10% of specimens had histological evidence of mycobacterial infection, one with co-existent aspergilloma. Mycobacteria were only identified in those patients with granulomas that were necrotising. These patients had higher exacerbation rates, lower TLCO and FEV1.ConclusionA proportion of severe COPD patients will have evidence of mycobacterial infection despite lack of clinical and radiological suspicion. This may have implications for long-term management of these patients.
Highlights
Patients with Chronic obstructive pulmonary disease (COPD) are at risk of non-tuberculous mycobacterial infection (NTM)
Pulmonary function tests showed a severe obstructive lung disease with a mean Forced expiratory volume in 1 sec (FEV1) of 36.3% of normal, and severe air trapping with a residual volume of >200% of normal
A small number of previous studies [8,12,13] have likewise found evidence of a wide range of histopathological diagnoses in addition to emphysema in surgical specimens, including neoplastic nodules and interstitial fibrosis, none of these studies have previously reported any evidence of mycobacterial disease on histology
Summary
Patients with COPD are at risk of non-tuberculous mycobacterial infection (NTM). This study examined the histology of lung tissue from COPD patients following lung volume reduction with particular focus on evidence of mycobacterial infection. Non-tuberculosis mycobacteria (NTM) are a group of widely distributed environmental mycobacteria (other than tuberculosis and leprosy). Pulmonary disease is the most common manifestation and is commonly diagnosed using American Thoracic Society (ATS) guidelines. The prevalence of NTM infection is increasing worldwide which. NTM are opportunistic bacteria and are more likely to cause disease when there are defects in local or systemic host immunity. Patients with preexisting lung conditions, such as COPD, cystic fibrosis (CF) and bronchiectasis, are shown to have a higher association with NTM infection [2,5,6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
