Pulmonary tuberculosis presenting secondary organizing pneumonia with organized polypoid granulation tissue: case series
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RESEARCH ARTICLE
Open Access
Pulmonary tuberculosis presenting secondary organizing pneumonia with organized polypoid granulation tissue: case series and review of the literature Eun Jin Kim*
and Kyung Chan Kim
Abstract Background: Secondary organizing pneumonia (SOP) is difficult to distinguish from cryptogenic organizing pneumonia (COP) considering various clinical situations. SOP caused by Mycobacterium tuberculosis is rare; indeed, it has not been reported as a sequela of disseminated tuberculosis. Methods: From January 2016 to December 2018, we identified six cases of tuberculosis-associated SOP in which Mycobacterium tuberculosis was revealed by microbiological examination; one of the cases was miliary tuberculosis. Results: Of the six cases, 17% were positive for acid fast bacillus (AFB) stain, but 100% were positive for M. tuberculosis polymerase chain reaction (MTB PCR) and AFB culture. In all cases, transbronchial lung biopsy was performed and organizing pneumonia was confirmed pathologically. All survived after treatment with antituberculosis therapy. Conclusions: Pulmonary tuberculosis, which shows OP in lung biopsy, is diagnosed through MTB PCR and AFB culture, and the prognosis is thought to be good. Keywords: Tuberculosis, Organizing pneumonia, Transbronchial lung biopsy
Background Organizing pneumonia (OP) is pathologically defined as the presence of organized polypoid granulation tissue in alveolar ducts and alveoli bronchioles, with or without bronchiolar organization [1, 2]. OP is classified as cryptogenic (idiopathic) OP (COP) or secondary OP (SOP). SOP refers to OP caused by a known cause, and representative examples include infection, connective tissue disease, drugs, inflammatory bowel disease, hematologic malignancies, organ transplantations and radiation therapy [2, 3]. Post-respiratory infection SOP
occurs after an infectious pneumonia, such as viruses, bacteria, fungi, or parasites [4, 5]. It can also be caused by Mycobacterium tuberculosis, although rarely [6–9]; to date, disseminated tuberculosis has not been reported as SOP. According to statistics in 2017, Korea is a country with a prevalence of tuberculosis in 70 people per 100, 000 population, but so far there has been only one case report on tuberculosis-related OP. Here, we report six cases of SOP that occurred after M. tuberculosis infection, including disseminated tuberculosis, and review the current literature.
* Correspondence: [email protected] Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu Catholic University School of Medicine, 33, Duryugongwon-ro 17-gil, Nam-gu, Daegu 42472, South Korea
Methods This retrospective study is based on a review of medical records of patients that underwent lung biopsy at the
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s)
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