Ogata Hiroaki, Harada Eiji, Takao Tomoaki, Ijichi Kayo, Hamada Naoki, Matsumoto Koichiro
Research Institute for Diseases of the Chest, Graduate School of Medical Sciences Kyushu University Fukuoka Japan.
Department of Respiratory Medicine National Hospital Organization Fukuoka National Hospital Fukuoka Japan.
Respirol Case Rep. 2020 Jun 28;8(6):e00608. doi: 10.1002/rcr2.608. eCollection 2020 Aug.
As opposed to tuberculosis, pleurisy hardly develops in patients with nontuberculous mycobacteria (NTM) infection. In spite of increasing prevalence of NTM infection, little is known about thoracoscopic or pathological findings of the NTM-infected pleura. We now report the first case of NTM pleuritis with multiple granulomatous nodules in the pleura. A 74-year-old woman was admitted to our hospital due to massive effusion of the left thoracic cavity. The analysis of pleural fluid showed lymphocytic exudative effusions with increased levels of adenosine deaminase, although culture of the pleural fluid was negative. The patient accordingly underwent thoracoscopy, which revealed multiple pleural nodules. Biopsy of the nodules demonstrated epithelioid cell granulomas without caseous necrosis. In addition, culture of the biopsy specimens confirmed infection by . As culture of pleural fluid often fails to detect NTM pathogens, demonstration of pleural nodules during thoracoscopy can contribute to prompt diagnosis and treatment of NTM pleuritis.
与肺结核不同，非结核分枝杆菌（NTM）感染患者很少发生胸膜炎。尽管NTM感染的患病率不断上升，但关于NTM感染胸膜的胸腔镜或病理表现却知之甚少。我们现在报告首例胸膜有多个肉芽肿性结节的NTM胸膜炎病例。一名74岁女性因左侧胸腔大量积液入住我院。胸水分析显示为淋巴细胞渗出性积液，腺苷脱氨酶水平升高，尽管胸水培养为阴性。该患者因此接受了胸腔镜检查，发现有多个胸膜结节。结节活检显示为上皮样细胞肉芽肿，无干酪样坏死。此外，活检标本培养证实感染了……由于胸水培养常常无法检测到NTM病原体，胸腔镜检查时发现胸膜结节有助于NTM胸膜炎的及时诊断和治疗。
