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