2015 Volume 29 Issue 1 Pages 31-36
We report three cases of pulmonary actinomycosis involving surgical resection. Case 1: An 87-year-old man presented complaining of bloody phlegm. Chest computed tomography revealed a 20-mm mass in the right middle lobe. Based on a suspected diagnosis of primary lung cancer, right middle lobe resection was performed, with a subsequent diagnosis of pulmonary actinomycosis. Case 2: A 73-year-old female undergoing follow-up for atypical mycobacterial disease was admitted with hemorrhagic shock resulting from massive hemoptysis. Bronchoscopic specimen culture was positive for pulmonary actinomycosis. To control hemoptysis, left basal segmentectomy was carried out. Case 3: A 65-year-old man presented complaining of bloody phlegm and back pain. Chest computed tomography revealed a 30-mm mass in the left upper lobe. Based on a suspected diagnosis of primary lung cancer, left upper superior segment resection was undertaken, with a subsequent diagnosis of pulmonary actinomycosis. In all three cases, there has been no recurrence of symptoms. Pulmonary actinomycosis is uncommon, and diagnosis difficult. Misdiagnosis as primary lung cancer is common, and the correct diagnosis is often obtained by pathological analysis following resection. Based on our results, physicians should consider resection in pulmonary actinomycosis patients who present with bloody phlegm, to lower the risk of hemoptysis.
