Evidence of mycobacterial disease in COPD patients with lung volume reduction surgery; the importance of histological assessment of specimens: a cohort study

BMC Pulmonary Medicine

Michael R Loebinger¹  Simon Jordan³  Robert Wilson¹  Philip Sedgwick²  Samuel J Clark³  Emily C Shaw³  Andrew G Nicholson¹  David M Hansell¹  Nick S Hopkinson¹  Anjali Char² 

[1] National Heart and Lung institute, Imperial College, London, UK;St. George’s, University of London, London, UK;Royal Brompton and Harefield NHS Foundation Trust, London, UK

关键词: Lung volume reduction surgery (LVRS);    Non tuberculous mycobacterium (NTM);    Mycobacterium;    COPD;   

Others  :  1109571
DOI  :  10.1186/1471-2466-14-124

 received in 2014-07-09, accepted in 2014-07-24,  发布年份 2014

【 摘 要 】

Background

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.

Methods

Retrospective 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.

Results

92% 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.

Conclusion

A 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.

【 授权许可】

   
2014 Char et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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