Mycobacterial Spindle Cell Pseudotumor of the Lung

Philip, J. R.; Beasley, Mary Beth; Dua, Sakshi

doi:10.1378/chest.11-2503

Cited by 15 publications

(12 citation statements)

References 5 publications

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“…Mycobacteria have been found in spindle cell pseudotumors (MSP). In most of the reported cases MSP occurs in the lymph node of inmunocompromised patients [8] and it should be noted that our patient had undergone radiotherapy so perhaps her autoinmune system had become compromised, allowing her to acquire the tuberculosis and then inflammatory pseudotumor appeared. Some 37% of all new cases of active tuberculosis infection are extrapulmonary tuberculosis [9] .…”

Section: Discussionmentioning

confidence: 86%

“…An abdominal radiograph can show splenomegalia and curvilinear calcifications along the inside edge of the spleen [14] . Computed tomography (CT) is not specific in differentiating between splenic IPT and other malignancies [8] . CT reveals a mass with a central hypodense area that may correspond to a necrotic zone surrounded by a hyperdense area with outlying hypodense zones [1,2,15] .…”

Section: Discussionmentioning

confidence: 99%

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Inflammatory pseudotumour of the spleen associated with splenic tuberculosis

Prieto-Nieto

Pérez-Robledo

Andres

et al. 2014

WJGS

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Inflammatory pseudotumor (IPT) of the spleen is an uncommon entity with an uncertain aetiology. Inflammatory pseudotumors present diagnostic difficulties because the clinical and radiological findings tend to suggest a malignancy. The symptoms include weight loss, fever, and abdominal pain. Most cases of splenic IPT present solitary relatively large well circumscribed masses on imaging. The diagnosis in the majority of the cases is made after histopathologic study of splenectomy specimens. The IPTs that occur in the spleen and liver are typically associated with Epstein-Barr virus. Thirtyseven percent of all new cases of active tuberculosis infection are extrapulmonary tuberculosis and tuberculous lymphadenitis the most commonly occurring form of extrapulmonary tuberculosis. We report the case of an inflammatory pseudotumor of the spleen associated with splenic tuberculous lymphadenitis in a 50-year-old female patient who was preoperatively diagnosed with a malignant spleen tumour based on her history of breast of carcinoma.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Inflammatory pseudotumour of the spleen associated with splenic tuberculosis

Prieto-Nieto

Pérez-Robledo

Andres

et al. 2014

WJGS

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“…Given the rarity of this condition, it has previously been unclear if treatment of MSP is beneficial; however, most of the reported cases have received treatment. Philip et al (15) presented a case in which an untreated patient returned a year later without pulmonary symptoms, but with radiologic evidence of progression. The lack of treatment for 3 months because of medication intolerance in our case allows us an opportunity to better understand the natural progression of this infectious condition in the setting of continued immunosuppression.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary mycobacterial spindle cell pseudotumor in a lung transplant patient: progression without therapy and response to therapy

Franco

Amoroso

Burke

et al. 2015

Transplant Infectious Dis

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Mycobacterial spindle cell pseudotumor (MSP) represents a rare, non-malignant, mass-forming reaction to various mycobacterial infections, typically occurring in immunocompromised patients. It is characterized by the proliferation of spindle-shaped fibrohistiocytic cells without the formation of epithelioid granulomas. Without staining for acid-fast bacilli, histological distinction from other spindle cell lesions, including malignancy, can be difficult. Most of the MSP cases reported in the literature have involved lymph nodes, skin, spleen, or bone marrow, but rarely involve the lung. MSP predominately occurs in patients who are immunosuppressed. We present a patient with MSP of the transplanted lung caused by non-tuberculous mycobacteria, in whom both the natural course of the untreated pseudotumor as well as the response to antimycobacterial treatments were observed.

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“…Most of the reported MSPs arise in immunocompromised patients, especially in patients with HIV infection or those treated with immunosuppressive drugs. Lymph nodes and skin are the most common sites of involvement, and spleen, brain and lung have also been described. Mycobacterium avium‐intracellulare complex was most commonly reported as the pathogen, but other species such as M. tuberculosis , M. kansasii and M. chelonae were also detected in a small number of cases.…”

Section: Discussionmentioning

confidence: 99%

“…Since it lacks features of epithelioid cell granuloma, histological distinction from neoplastic spindle cell proliferation is often problematic. Although MSPs have been described mainly in immunocompromised patients in various sites including lymph nodes, skin, spleen, brain and lung, MSP of the nasal cavity is extremely rare and only two cases have been reported previously . Here we report a case of MSP of the nasal cavity in an 83‐year‐old man without evidence of immunodeficient state.…”

mentioning

confidence: 84%

Nontuberculous mycobacteria‐associated spindle cell pseudotumor of the nasal cavity: A case report

Ohara

Kimura

Sakamoto

et al. 2013

Pathology International

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Mycobacterial spindle cell pseudotumor (MSP) is a rare mass-forming lesion caused by mycobacterial infection, mostly in immunocompromised patients. Since it is composed of a proliferation of spindle-shaped fibrohistiocytic cells without forming epithelioid cell granulomas, histological distinction from other spindle cell lesions is often difficult and its pathophysiology is poorly understood. MSP arising in the nasal cavity is extremely rare, and only two cases have been reported previously. Here we report a case of MSP of the nasal cavity in an 83-year-old man with no evidence of immunodeficient state. The resected tumor consisted of spindle cells, which contained numerous acid-fast bacilli in the cytoplasm. By polymerase chain reaction and sequencing using DNA extracted from the paraffin sections, the bacilli were identified as Mycobacterium intracellulare. Immunohistochemistry revealed that the spindle cells were positive for CD68, CD11c and S100 protein, confirming the histiocytic nature of these cells. They were also positive for CD163 and CD204, suggesting that they showed a phenotype similar to alternatively activated (M2) macrophages and the phenotype might contribute to the maintenance of mycobacterial infection despite apparent immunocompetence of the host.

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Mycobacterial Spindle Cell Pseudotumor of the Lung

Cited by 15 publications

References 5 publications

Inflammatory pseudotumour of the spleen associated with splenic tuberculosis

Inflammatory pseudotumour of the spleen associated with splenic tuberculosis

Pulmonary mycobacterial spindle cell pseudotumor in a lung transplant patient: progression without therapy and response to therapy

Nontuberculous mycobacteria‐associated spindle cell pseudotumor of the nasal cavity: A case report

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