Fig. 18.8 Tumor emboli and lymphangitic carcinomatosis along bronchovascular bundles showing vascular tree-in-bud signs in a 34-year- old woman with gastric cancer. (a, b) Lung window images of thin-section CT scans (1.5-mm section thickness) obtained at levels of cardiac ventricle (a) and liver dome (b), respectively, show thickened axial interstitium (bronchovascular bundles) (open arrows) and several foci of tree-in-bud signs (arrows) in both lungs. (c) High-magnification

(×100) photomicrograph of surgical lung biopsy specimen from another patient demonstrates dilated arterioles (arrows) with thickened wall. Please note intravascular tumor emboli (arrowhead). There are many hemosiderin-laden macrophages in alveolar spaces. (d) Another photomicrograph (×100) discloses an arteriole with thick wall containing intraluminal tumor emboli (arrowhead)

debris, thus resulting in cavity formation and bronchogenic spread of the infection. Cavitary form of NTM infection on TSCT represents this stage of inflammation mainly involving relatively large airways and more extensive inflammation.

Mycobacterium abscessus infection is quite resistant to medical therapy [25]. Surgical resection is the one of the treatment options if the lung lesion is localized.

Patient Prognosis

Making a diagnosis of NTM lung disease does not necessitate the institution of therapy. Decision to treat or not should be based on the potential risk and benefit of long-term medical therapy and on the species of NTM [24]. In particular,

Diffuse Panbronchiolitis

Pathology and Pathogenesis

DPB is a distinctive inflammatory condition characterized by chronic bronchiolitis associated with prominent interstitial vacuolated or “foamy” histiocytes in a peribronchiolar