CTICasesEndobronchial Mycobacterium avium Complex (MAC) Infection
Imaging findings
Frontal and lateral chest radiographs demonstrate a subtle left hilar soft tissue opacity. Chest CT, performed as a pulmonary embolism study, reveals a focal endobronchial mass in the left main bronchus causing mild airway narrowing, along with adjacent subcarinal lymphadenopathy. Bronchoscopy and biopsy showed necrotic tissue and granulomas, with cultures positive for Mycobacterium avium complex.
Key takeaways
Although endobronchial mycobacterial infections typically present with circumferential and multicentric airway thickening, they can rarely present as a solitary, focal endobronchial mass mimicking a neoplasm. A rapid growth rate over just a few months in an immunocompromised host, such as a patient with HIV, should prompt consideration of an infectious granulomatous process.
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