Cavity Wall in Classic MAC Disease

Cavity with Thick Wall

This image is from the wall (0.5 cm thick) of an upper lobe cavity (lumen at left) of a 57-year-old man with COPD and MAC disease.

gran1gran2

 

Ill-defined granulomas with epithelioid cells and giant cells are mingled with looser granulation tissue with small blood vessels and chronic inflammatory cells. Note intimal thickening and narrowing of the artery, a complication of chronic inflammation, at the bottom right,.

Find two ill-defined granulomas.

Cavity size and wall thickness are not reliable criteria to distinguish NTM disease from tuberculosis on radiographs.

Reference

Levin D. Radiology of pulmonary Mycobacterium avium-intracellulare complex. Clin Chest Med 2002; 23:603-612.

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Ill-defined granuloma

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