Evidence of mycobacterial disease in COPD patients with lung volume reduction surgery; the importance of histological assessment of specimens: A cohort study

Loebinger, Michael R.; Clark, Samuel J.; Shaw, Emily C.; Nicholson, Andrew G.; Hansell, David M.; Hopkinson, Nick S.; Char, Anjali; Hansell, David M; Sedgwick, Philip; Wilson, Robert; Jordan, Simon

Abstract

© 2014 Char et al.; licensee BioMed Central Ltd. Background: Patients with COPD are at risk of non-tuberculous mycobacterial infection (NTM). This study examined the histology of lung tissue from COPD patients following lung volume reduction with particular focus on evidence of mycobacterial infection.Methods: Retrospective histological study of 142 consecutive lung volume reduction surgical specimens (126 separate patients) at Royal Brompton Hospital between 2000 - 2013, with prospectively collected preoperative data on exacerbation rate, lung function and body mass index.Results: 92% of patients had at least one other histological diagnosis in addition to emphysema. 10% of specimens had histological evidence of mycobacterial infection, one with co-existent aspergilloma. Mycobacteria were only identified in those patients with granulomas that were necrotising. These patients had higher exacerbation rates, lower TLCO and FEV 1 .Conclusion: A proportion of severe COPD patients will have evidence of mycobacterial infection despite lack of clinical and radiological suspicion. This may have implications for long-term management of these patients.

Citation

Loebinger, M. R., Clark, S. J., Shaw, E. C., Nicholson, A. G., Hansell, D. M., Hopkinson, N. S., …Jordan, S. (2014). Evidence of mycobacterial disease in COPD patients with lung volume reduction surgery; the importance of histological assessment of specimens: A cohort study. BMC Pulmonary Medicine, 14(1), 1-7. https://doi.org/10.1186/1471-2466-14-124

• Journal Article Type: Article
• Publication Date: Aug 2, 2014
• Deposit Date: Aug 8, 2014
• Publicly Available Date: Nov 15, 2016
• Journal: BMC Pulmonary Medicine
• Electronic ISSN: 1471-2466
• Publisher: BioMed Central
• Peer Reviewed: Peer Reviewed
• Volume: 14
• Issue: 1
• Pages: 1-7
• DOI: https://doi.org/10.1186/1471-2466-14-124
• Keywords: COPD, lung volume reduction surgery, mycobacterial
• Public URL: https://uwe-repository.worktribe.com/output/813788
• Publisher URL: http://www.biomedcentral.com/1471-2466/14/124