497
Diagnosis of the case presented in the previous edition
J Bras Pneumol 2004;30(4):496
NONTUBERCULOUS MYCOBACTERIOSIS
Correct diagnoses of the case presented in the July/August 2004 issue were
submitted by:
Some nontuberculous Mycobacterium species can also cause pulmonary diseases, often in forms i n d i s t i n g u i s h a b l e f r o m t h o s e c a u s e d b y Mycobacterium tuberculosis.
A m o n g t h e p r i n c i p a l n o n t u b e r c u l o u s M y c o b a c t e r i u m s p e c i e s a r e t h e M . a v i u m intracellulare complex, M. kansasii and M. xenopi. Of these, infections caused by the M. avium intracellulare complex are becoming increasingly more common, particularly in patients with cellular immunodeficiency or chronic pulmonary diseases. Such infections are more frequently seen in patients who are elderly, white and female.
The characteristics of the radiological findings in relation to those of tuberculosis include: 1. As for the extent of parenchymal involvement,
cavitation appears earlier and the walls may be thinner and surrounded by less affected parenchyma;
2. The anterior segments of the superior lobes, and, primarily, the middle lobe and the lingula, are more frequently involved;
3. Pleural effusion is rare and, when present, is minimal; 4. Lymph node enlargement is uncommon; 5 . T h e p r i n c i p a l f i n d i n g s a r e o p a c i t i e s
circumscribed by irregular translucent areas, nodules and bronchiectasis.
REFERENCES
1. Aquino SL, Gamsu G, Webb WR, Kee ST. Tree-in-bud pattern: frequency and significance on thin section CT. J Comput Assist Tomogr 1996; 20:594-9.
2. Itoh H, Tokunaga S, Asamoto H, et al. Radiologic-pathologic correlations of small lung nodules with special reference to peribronchiolar nodules. AJR Am J Roentgenol 1978; 130:223-31.
3. Moore EH. Atypical mycobacterial infection in the lung: CT appearance. Radiology 1993; 187:777-82.
4. Hwang JH, Kim TS, Han J, Lee KS. Primary lymphoma o f t h e l u n g s i m u l a t i n g b r o n c h i o l i t i s : r a d i o l o g i c findings. AJR Am J Roentgenol 1998; 170:220-1.
André L. S. Becker - Hospital Fátima, Caxias do Sul
Cláudia Beatriz A. Rebello - Pará
José Antonio Baddini Martinez - Faculdade de Medicina de Ribeirão Preto, FMRP-USP
Lílian Pinto de Azevedo Oliveira - SAMER Hospital, Resende, RJ
Mauricio Mello Roux Leite - Hospital Nossa Senhora da Conceição, Porto Alegre, RS
