Pulmonary mycobacteriosis in patients following resection of lung cancer

Abstract

Objective. This study assessed pulmonary mycobacteriosis in patients who had undergone pulmonary resection for lung cancer. Methods. The medical records of 24 pulmonary mycobacteriosis patients following resection of lung cancer, between 1996 and 2007, were retrospectively reviewed. The clinical course, laboratory findings, and radiological findings of these patients were analyzed. Results. There were 14 pulmonary tuberculosis (PTB) cases and 10 non-tuberculous mycobacteriosis (PNTM, Mycobacterium avium complex in 9 and Mycobacterium kansasii in 1) cases, 17 were men, 15 were elderly, the postoperative period was less than 5 years in 15 cases and 18 cases were located in the resected side of the lung. Seven of the 14 PTB cases had recurrence of lung cancer, 6 had a previous history of PTB treatment, 5 had a previous history of other malignancies, and 5 were in performance status (PS) 2, or more than PS 2. These findings suggest that endogenous reactivation may be associated with the onset of PTB. Most of these systemic factors were not present in the 10 PNTM cases, but the fact that 9 of the 10 had a PNTM lesion in the resected side of the lung suggests that aggravation of the pulmonary microenvironment caused by surgery is associated with the onset and progression of PNTM. PTB treatment was effective and the outcome was good if there was no delay in diagnosis. However, the condition of some PNTM cases deteriorated despite treatment, and developed other pulmonary infections such as pulmonary aspergillosis, which were fatal. Conclusion. Careful observation for systemic and radiographic changes is necessary to accurately diagnose pulmonary mycobacteriosis after resection of lung cancer. © 2010 The Japan Lung Cancer Society.