2016 Volume 38 Issue 4 Pages 285-290
Background. The diagnostic rate of pulmonary actinomycosis by bronchoscopy is reportedly low. Case. A 62-year-old woman complained of bloody sputum, which had started three weeks before admission to a neighborhood hospital. Chest computed tomography (CT) indicated a mass in the right upper lobe, and the patient was referred to another hospital. Bronchoscopy was performed but was not contributory in making a diagnosis. The bloody sputum persisted and the mass on CT enlarged. She was then referred to our hospital. She had untreated dental caries and diabetes. CT revealed a mass with central low attenuation areas, raising the possibility of pulmonary actinomycosis in the differential diagnosis. To collect a specimen from the central part of the mass, bronchoscopy using endobronchial ultrasonography with a guide-sheath (EBUS-GS) method was performed. Brushing cytology revealed sulfur granules characteristic of actinomycosis. Conclusions. The suspicion of pulmonary actinomycosis necessitated collection of a specimen from the deep part of the lesion. Bronchoscopy by the EBUS-GS method was useful for making the diagnosis.
