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Ann Thorac Surg 1996;62:990-993
© 1996 The Society of Thoracic Surgeons

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Original Articles: General Thoracic

Resection of the Right Middle Lobe and Lingula for Mycobacterial Infection

Division of Cardiothoracic Surgery, Department of Surgery, University of Colorado Health Sciences Center, and Clinical Mycobacterial Service, Division of Infectious Disease in the Department of Medicine, The National Jewish Center for Immunology and Respiratory Medicine, Denver, Colorado

Background. In a series of 229 patients infected with mycobacterial organisms, we noted a specific female phenotype that involves isolated infections of the middle lobe and lingula.

Methods. Thirteen patients were found to have infections of the middle lobe, lingula, or both. All of them were infected with Mycobacterium other then Mycobacterium tuberculosis, all were women, 12 of the 13 were slender, and most had variable combinations of skeletal abnormalities. All underwent resection of the middle lobe, lingula, or both.

Results. There were no operative deaths. Only 2 patients have had reactivation requiring additional antibiotic therapy. All patients have had a decreased number of pulmonary infections in the postoperative period. Anatomic findings at operation included a complete major fissure and at least a partially complete minor fissure with middle lobe resections or an elongated lingula.

Conclusions. Mycobacterial infection of the middle lobe and lingula is primarily a disease of asthenic women and is often associated with skeletal abnormalities and complete fissures or an elongated lingula. We recommend that surgical intervention be performed early once the condition is identified.

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Discussion
Ann. Thorac. Surg. 1996 62: 993. [Extract] [Full Text]

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