[A case of pulmonary actinomycosis with recurrent hemoptysis diagnosed after right upper lobectomy]

The patient was a 58-year-old man who had been admitted in 1995 because of hemoptysis. Chest CT scans showed air-space consolidation with dilated bronchi and calcification in the right S3. He received a diagnosis of bronchiectasis with old tuberculosis. Bronchial arteriography showed arterialization in the right S3, and bronchial artery embolization was performed. But in 1996 hemoptysis reappeared. He was readmitted in May 1999 because of recurrent hemoptysis. Bronchial arteriography showed recurrence of arterialization in the same area, and chest CT scans showed growth of the mass shadow. Right upper lobectomy was performed, and the microscopic findings of the resected specimen showed sulfur granules in the dilated bronchus. We concluded that pulmonary actinomycosis should be considered in the differential diagnosis of abnormal chest shadows.