| Title: |
Micro-computed Tomographic Analysis of Non-tuberculous Mycobacterial Lung Disease |
| Authors: |
Chan, E.D.; Wells, G.; Mitchell, J.; Cassell, G.H.; Glasgow, J.; Bai, X.; Narum, D.; Merrick, D.; Van Bokhoven, A.; Steyn, A. |
| Source: |
American Journal of Respiratory and Critical Care Medicine ; volume 211, issue Supplement_1, page A7275-A7275 ; ISSN 1073-449X 1535-4970 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2025 |
| Description: |
RATIONALE: Non-tuberculous mycobacteria (NTM) are responsible for chronic lung diseases that are relentlessly progressive and often recalcitrant to treatment. NTM lung disease is an airway-centric disorder characterized by bronchiectasis, bronchiolitis, nodules, atelectasis, and consolidation with or with cavitation. Histopathologic analyses of surgically resected NTM lung tissues revealed that computed tomographic (CT) findings of bronchiectasis and bronchiolitis correlated with peribronchial and peribronchiolar granulomatous inflammation and airway wall necrosis. A three-dimensional analysis of the granulomas found in human pulmonary tuberculosis using micro-CT, histopathology, and immunohistochemistry revealed that, unlike the typical description of TB granulomas as round discrete structures, human necrotic TB granulomas demonstrated cylindrical, branched morphologies which are connected to the airways and shaped by the bronchi, supporting the bronchogenic spread of Mycobacterium tuberculosis. Furthermore, the lack of vascularization within the obstructed bronchi likely enabled further necrosis and poor penetration of immune cells and antibiotics to the affected lung segments. METHODS: Thus, we undertook a pilot micro-CT study of surgically resected lung tissues from 13 people with NTM lung disease, contrast-stained with phosphotungstic acid – which allows for better visualization of lesions compared to surrounding tissue – and rescanned. RESULTS: We detected calcifications in the lung samples scanned without contrast staining, likely a healing granulomatous response as seen with tuberculosis. We also detected volumes of lower attenuation that correspond to lesions induced by the NTM infection. Similarly to tuberculosis, contrast staining allowed for identification and visualization necrotic lesions, blood vessels, airways and cavities. Staining and rescanning revealed complex structures that appear to be formed by coalescing lesions. Some lesions appear to merge into airways or cavities. ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1164/ajrccm.2025.211.abstracts.a7275 |
| Availability: |
https://doi.org/10.1164/ajrccm.2025.211.abstracts.a7275; https://academic.oup.com/ajrccm/article-pdf/211/Supplement_1/A7275/67058252/ajrccm_211_abstracts_a7275.pdf |
| Rights: |
https://academic.oup.com/pages/standard-publication-reuse-rights |
| Accession Number: |
edsbas.D7249B14 |
| Database: |
BASE |