1994 Volume 33 Issue 6 Pages 1119-1123
A 58-year-old man with pulmonary actinomycosis diagnosed by bronchial brushing cytology is reported.He came to our hospital complaining of cough and blood in his sputum.A chest X-ray revealed an infiltrative shadow in the left upper lobe of the lung.Bronchial brush specimens were obtained, and cytological examination revealed Actinomyces organisms in clusters.Antibiotic therapy was started immediately.He experienced pulmonary hemorrhage during treatment in the clinic and was admitted. Repeated transbronchial biopsy and brush specimens were obtained, and cytological and histological examination established the diagnosis of pulmonary actinomycosis.Left upper lobectomy was then performed.The cytological features of the Actinomyces organisms were aggregated “sulphur granules” hforming irregular islands of amorphous clumps.The color of these aggregates was green to yellowish brown, and they possessed numerous filamentous structures radiating from the center.
Organisms exhibiting branching, spores and septa were observed on the silver stained specimen.
Histochemically, the sulfur granules stained diffusely with periodic acid-Schiff (PAS), alcian-blue and mucicarmine stain, suggesting that they are composed of numerus filamentous organisms and mucopolysaccharides.
