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1652. Diagnoses of Non- Tuberculosis Mycobacterium (NTM) in patients with granuloma on lung biopsy

BACKGROUND: The prevalence of non-Tuberculous mycobacteria (NTM) lung disease has increased from 8.7 to 13.9/100,000 from 2008-2013 making NTM lung disease a rising public health problem. Patterns of infection include fibrocavitary, bronchiectatic or nodular. Diagnosis of NTM may be incidental after...

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Autores principales: Singh, Vansha, Kim, Angela, Hayes, Lisa, Rasul, Rehana, Schwartz, Rebecca, Epstein, Marcia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777175/
http://dx.doi.org/10.1093/ofid/ofaa439.1830
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author Singh, Vansha
Kim, Angela
Hayes, Lisa
Rasul, Rehana
Schwartz, Rebecca
Epstein, Marcia
Epstein, Marcia
author_facet Singh, Vansha
Kim, Angela
Hayes, Lisa
Rasul, Rehana
Schwartz, Rebecca
Epstein, Marcia
Epstein, Marcia
author_sort Singh, Vansha
collection PubMed
description BACKGROUND: The prevalence of non-Tuberculous mycobacteria (NTM) lung disease has increased from 8.7 to 13.9/100,000 from 2008-2013 making NTM lung disease a rising public health problem. Patterns of infection include fibrocavitary, bronchiectatic or nodular. Diagnosis of NTM may be incidental after surgical resection performed during malignancy work up. We aimed to identify the proportion of NTM in resected lung lesions (both nodules and masses) with granulomas (GL) both necrotizing (NGL) and non-necrotizing (n-NGL) on pathology and to compare differences in characteristics of patients with NTM versus those without NTM. METHODS: This was a retrospective chart review of patients who underwent resection of lung nodules and/or a lung mass during malignancy work up from January 2013 through March 2019 including only those with granulomatous inflammation on pathology. 497 patients met these criteria and their electronic medical records were reviewed. Findings of culture-confirmed NTM on tissue, bronchoalveolar lavage or sputum (at time of resection) were classified as “NTM” group; and those with no NTM diagnoses were classified as “Non-NTM” group. Patients with NTM and another diagnoses were classified within the NTM group. Study variables were compared by the dichotomous NTM group using Chi-square test for categorical variables and T-test for continuous variables. RESULTS: Among all patients, the most common diagnosis was lung cancer (21.93%). There were 81 (16.3%) patients with NTM (Table 1). Within the NTM group, percentage of Asians, presence of NGL, placement on airborne precautions and prior history of tuberculosis were significantly higher. The NTM group also had a higher proportion of both COPD and lung cancer as their underlying condition (Table 2). 161 patients had non-diagnostic biopsies. Table 1 [Image: see text] Table 2 [Image: see text] Table 2 [Image: see text] CONCLUSION: Mycobacterial infections made up a significant percentage of resected lung nodules and/or lung masses for malignancy evaluation. NTM were isolated with greater frequency than M. Tuberculosis even with NGL on lung pathology. This reflects the changing epidemiology of NTM. The significant proportion of Asians with NTM compared with GL found during a malignancy work up without NTM is interesting and deserves further investigation. DISCLOSURES: All Authors: No reported disclosures
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spelling pubmed-77771752021-01-07 1652. Diagnoses of Non- Tuberculosis Mycobacterium (NTM) in patients with granuloma on lung biopsy Singh, Vansha Kim, Angela Hayes, Lisa Rasul, Rehana Schwartz, Rebecca Epstein, Marcia Epstein, Marcia Open Forum Infect Dis Poster Abstracts BACKGROUND: The prevalence of non-Tuberculous mycobacteria (NTM) lung disease has increased from 8.7 to 13.9/100,000 from 2008-2013 making NTM lung disease a rising public health problem. Patterns of infection include fibrocavitary, bronchiectatic or nodular. Diagnosis of NTM may be incidental after surgical resection performed during malignancy work up. We aimed to identify the proportion of NTM in resected lung lesions (both nodules and masses) with granulomas (GL) both necrotizing (NGL) and non-necrotizing (n-NGL) on pathology and to compare differences in characteristics of patients with NTM versus those without NTM. METHODS: This was a retrospective chart review of patients who underwent resection of lung nodules and/or a lung mass during malignancy work up from January 2013 through March 2019 including only those with granulomatous inflammation on pathology. 497 patients met these criteria and their electronic medical records were reviewed. Findings of culture-confirmed NTM on tissue, bronchoalveolar lavage or sputum (at time of resection) were classified as “NTM” group; and those with no NTM diagnoses were classified as “Non-NTM” group. Patients with NTM and another diagnoses were classified within the NTM group. Study variables were compared by the dichotomous NTM group using Chi-square test for categorical variables and T-test for continuous variables. RESULTS: Among all patients, the most common diagnosis was lung cancer (21.93%). There were 81 (16.3%) patients with NTM (Table 1). Within the NTM group, percentage of Asians, presence of NGL, placement on airborne precautions and prior history of tuberculosis were significantly higher. The NTM group also had a higher proportion of both COPD and lung cancer as their underlying condition (Table 2). 161 patients had non-diagnostic biopsies. Table 1 [Image: see text] Table 2 [Image: see text] Table 2 [Image: see text] CONCLUSION: Mycobacterial infections made up a significant percentage of resected lung nodules and/or lung masses for malignancy evaluation. NTM were isolated with greater frequency than M. Tuberculosis even with NGL on lung pathology. This reflects the changing epidemiology of NTM. The significant proportion of Asians with NTM compared with GL found during a malignancy work up without NTM is interesting and deserves further investigation. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2020-12-31 /pmc/articles/PMC7777175/ http://dx.doi.org/10.1093/ofid/ofaa439.1830 Text en © The Author 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Poster Abstracts
Singh, Vansha
Kim, Angela
Hayes, Lisa
Rasul, Rehana
Schwartz, Rebecca
Epstein, Marcia
Epstein, Marcia
1652. Diagnoses of Non- Tuberculosis Mycobacterium (NTM) in patients with granuloma on lung biopsy
title 1652. Diagnoses of Non- Tuberculosis Mycobacterium (NTM) in patients with granuloma on lung biopsy
title_full 1652. Diagnoses of Non- Tuberculosis Mycobacterium (NTM) in patients with granuloma on lung biopsy
title_fullStr 1652. Diagnoses of Non- Tuberculosis Mycobacterium (NTM) in patients with granuloma on lung biopsy
title_full_unstemmed 1652. Diagnoses of Non- Tuberculosis Mycobacterium (NTM) in patients with granuloma on lung biopsy
title_short 1652. Diagnoses of Non- Tuberculosis Mycobacterium (NTM) in patients with granuloma on lung biopsy
title_sort 1652. diagnoses of non- tuberculosis mycobacterium (ntm) in patients with granuloma on lung biopsy
topic Poster Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777175/
http://dx.doi.org/10.1093/ofid/ofaa439.1830
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