PubMed · 13066406
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E MULLER, K POPPENDIECK. 1953. [Bronchiectasis and tuberculosis].. https://pubmed.ncbi.nlm.nih.gov/13066406/
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The occurrence of follicular bronchiolitis (FB), lymphoid hyperplasia of the bronchus-associated lymphoid tissue, is reported in association with several systemic rheumatic diseases. However, the occurrence of FB in patients with giant cell arteritis (GCA) is not described. A 64-year-old man with long-standing GCA subsequently presented with haemoptysis. A mass in the lower lobe of the left lung was seen on chest x-ray and computed tomography. A wedge resection was performed, and histological examination revealed bronchiectasis, granulation tissue and hyperplasia of peribronchiolar lymphoid aggregates, consistent with FB. FB should be included in the differential diagnosis of haemoptysis in patients with systemic rheumatic diseases.
Nontuberculous Mycobacteria (NTM), especially Mycobacterium avium-intracellulare complex (MAC), has been considered responsible for human disease, especially in HIV patients. Nevertheless, it has been diagnosed in immunocompetent elderly men, frequently with previous pulmonary disease: chronic obstructive lung disease (COPD), complications of tuberculosis, pulmonary fibrosis and bronchiectasis. We relate the case of a female patient, 51 years old, with continuously acid fast bacilli (AFB) smears and with three previous treatments, which were conducted at the multiresistant tuberculosis (MRTB) service. MAC was identified in the sputum culture, and she received treatment for one year. The posterior sputum exams were negative. The cavity lesions observed in the high-resolution computed tomography (HRCT) were reduced, and some of the nodule lesions became bronchiectasis, even after the end of treatment. We agree with the literature reports that indicate that MAC is the cause of bronchiectasis. It is necessary to identify the type of mycobacteria in immunocompetent individuals with positive AFB smears that do not become negative with tuberculosis treatment.
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