Pulmonary tuberculosis presenting secondary organizing pneumonia with organized polypoid granulation tissue: case series and review of the literature

Eun Jin Kim,Kyung Chan Kim

doi:10.1186/s12890-020-01292-7

Abstract

BackgroundSecondary organizing pneumonia (SOP) is difficult to distinguish from cryptogenic organizing pneumonia (COP) considering various clinical situations. SOP caused by Mycobacterium tuberculosis is rare; indeed, it has not been reported as a sequela of disseminated tuberculosis.MethodsFrom January 2016 to December 2018, we identified six cases of tuberculosis-associated SOP in which Mycobacterium tuberculosis was revealed by microbiological examination; one of the cases was miliary tuberculosis.ResultsOf the six cases, 17% were positive for acid fast bacillus (AFB) stain, but 100% were positive for M. tuberculosis polymerase chain reaction (MTB PCR) and AFB culture. In all cases, transbronchial lung biopsy was performed and organizing pneumonia was confirmed pathologically. All survived after treatment with anti-tuberculosis therapy.ConclusionsPulmonary tuberculosis, which shows OP in lung biopsy, is diagnosed through MTB PCR and AFB culture, and the prognosis is thought to be good.

Highlights

Secondary organizing pneumonia (SOP) is difficult to distinguish from cryptogenic organizing pneumonia (COP) considering various clinical situations
Occurs after an infectious pneumonia, such as viruses, bacteria, fungi, or parasites [4, 5]. It can be caused by Mycobacterium tuberculosis, rarely [6,7,8,9]; to date, disseminated tuberculosis has not been reported as SOP
After 2 weeks, chest X ray (CXR) was unable to rule out malignancy and did not improve, so computed tomography (CT) was taken

Summary

Introduction

Secondary organizing pneumonia (SOP) is difficult to distinguish from cryptogenic organizing pneumonia (COP) considering various clinical situations. SOP caused by Mycobacterium tuberculosis is rare; it has not been reported as a sequela of disseminated tuberculosis. OP is classified as cryptogenic (idiopathic) OP (COP) or secondary OP (SOP). Post-respiratory infection SOP occurs after an infectious pneumonia, such as viruses, bacteria, fungi, or parasites [4, 5]. It can be caused by Mycobacterium tuberculosis, rarely [6,7,8,9]; to date, disseminated tuberculosis has not been reported as SOP. We report six cases of SOP that occurred after M. tuberculosis infection, including disseminated tuberculosis, and review the current literature

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Discussion

Conclusion