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[Postoperatively Diagnosed Pulmonary Actinomycosis;Report of Three Cases]

Hisao Ishida1, Masaki Murasawa, Masatoshi Yoshizawa

  • 1Department of General Thoracic Surgery, The Second Okamoto General Hospital, Uji, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|September 3, 2015
PubMed

Insights

Pulmonary actinomycosis is often misdiagnosed as lung cancer, posing diagnostic challenges. Early surgical intervention and pathological examination are crucial for accurate diagnosis and treatment of this rare fungal infection.

Area of Science:

  • Pulmonology
  • Infectious Diseases
  • Thoracic Surgery

Background:

  • Pulmonary actinomycosis is a rare bacterial infection that can mimic lung cancer clinically and radiologically.
  • Accurate preoperative diagnosis of pulmonary actinomycosis is challenging, often leading to misdiagnosis as lung cancer.

Observation:

  • Three male patients with pulmonary actinomycosis were diagnosed postoperatively over three years.
  • Radiological findings included mass-like shadows and cavitary lesions, with high fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET).
  • Clinical presentation and initial biopsies suggested lung cancer in all cases, necessitating surgical intervention.

Findings:

  • All three patients underwent lobectomy (right upper or lower), with one requiring chest wall resection due to suspected cancer invasion.
  • Postoperative pathological examination confirmed pulmonary actinomycosis in all cases.
  • The diagnostic difficulty highlights the importance of considering actinomycosis in the differential diagnosis of lung masses.

Implications:

  • This case series underscores the need for increased awareness of pulmonary actinomycosis among clinicians.
  • Improved diagnostic strategies are needed to differentiate actinomycosis from lung cancer preoperatively.
  • Timely diagnosis and appropriate treatment can prevent unnecessary radical surgeries for lung cancer.

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