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Original article
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. 1 Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine and New York Presbyterian Hospital, New York, New York, USA
  2. 2 Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, New York, USA
  3. 3 Department of Pathology, Mayo Clinic, Rochester, New York, USA
  4. 4 Division of Hematology/Oncology, Weill Cornell Medicine and New York Presbyterian Hospital, New York, New York, USA
  5. 5 Department of Pathology, Weill Cornell Medicine and New York Presbyterian Hospital, New York, New York, USA
  6. 6 Transplantation-Oncology Infectious Diseases Program, Weill Cornell Medicine and New York Presbyterian Hospital, New York, New York, USA
  7. 7 Department of Pediatrics, Weill Cornell Medicine and New York Presbyterian Hospital, New York, New York, USA
  8. 8 Department 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

https://doi.org/10.1136/jclinpath-2017-204777

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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.