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Mycobacterial spindle cell pseudotumour: epidemiology and clinical outcomes
  1. Maroun M Sfeir1,2,
  2. Audrey Schuetz3,
  3. Koen Van Besien4,
  4. Alain C Borczuk5,
  5. Rosemary Soave1,6,
  6. Stephen G Jenkins5,
  7. Thomas J Walsh1,6,7,8,
  8. Catherine B Small1,6
  1. 1Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine and New York Presbyterian Hospital, New York, New York, USA
  2. 2Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, New York, USA
  3. 3Department of Pathology, Mayo Clinic, Rochester, New York, USA
  4. 4Division of Hematology/Oncology, Weill Cornell Medicine and New York Presbyterian Hospital, New York, New York, USA
  5. 5Department of Pathology, Weill Cornell Medicine and New York Presbyterian Hospital, New York, New York, USA
  6. 6Transplantation-Oncology Infectious Diseases Program, Weill Cornell Medicine and New York Presbyterian Hospital, New York, New York, USA
  7. 7Department of Pediatrics, Weill Cornell Medicine and New York Presbyterian Hospital, New York, New York, USA
  8. 8Department of Microbiology and Immunology, Weill Cornell Medicine and New York Presbyterian Hospital, New York, New York, USA
  1. Correspondence to Dr Maroun M Sfeir, Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine of Cornell University, New York, NY 10065, USA; mas9469{at}med.cornell.edu

Abstract

Introduction Mycobacterial spindle cell pseudotumour (MSP) is a rare disease characterised by tumour-like local proliferation of spindle-shaped histiocytes containing acid-fast positive mycobacteria. The aim of this literature review is to describe the clinical parameters and treatment outcomes of patients with MSP.

Methods A literature search was conducted using the search terms related to mycobacteria and spindle cell tumours. A previously unreported stem cell transplant recipient from our institution diagnosed with MSP was also included. Demographics, comorbidities, site of infection, treatment and clinical outcomes were analysed.

Results Fifty-one patients were analysed. Twenty-six (51%) had HIV infection. Mycobacterium avium complex was the most frequent organism isolated in 24 (47.1%) followed by Mycobacterium tuberculosis complex in eight (16%) cases. Lymph nodes were the most common site of infection (45.1%). Twenty (39.2%) patients received antimycobacterial agents, 12 (23.5%) underwent surgical resection and six (11.8%) received antimycobacterial agents plus surgery. Treatment was successful in 24 (47.1%) patients and failed in 15 (29.4%); 13 of these 15 patients died. Antimycobacterial therapy was significantly associated with successful outcome compared with surgical resection or no treatment (P<0.001).

Conclusion MSP is a rare condition associated primarily with immunodeficiencies. Antimycobacterial therapy is significantly associated with successful outcome.

  • mycobacteria
  • immunodeficiency
  • immunocomprised host
  • infections

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Footnotes

  • Handling editor Tony Mazzulli.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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