Actinomycosis: pulmonary manifestations on chest radiographs

Case contributed by Dr Jayanth Keshavamurthy

Presentation

Multiple episodes of RUL pneumonia history of tobacco use, concern for post-obstructive pneumonia, please evaluate for possible lung mass"

Patient Data

Age: 55
Gender: Male

Spot the abnormal lobe

Modality: X-ray

Frontal and lateral view of the chest demonstrate chronic interstitial lung markings, which are actually more prominent in the right upper lobe and right lower lobe suggestive of scarring. This is stable for 10 years. There is interposition of colon between liver and right hemidiaphragm.

8 years later the chest X ray shows

Modality: X-ray

Right upper lobe findings are similar. Grossly no change.

Final Pathologic Diagnosis on Bronchoscopy in 2007

LUNG, POSTERIOR SEGMENT OF RIGHT UPPER LOBE (ENDOBRONCHIAL BIOPSY):
-  Benign bronchial mucosa demonstrating moderate to severe acute    

  and chronic inflammation, squamous metaplasia and

  micro-organisms consistent with actinomycetes group.

 

 GMS:  Positively staining filamentous branching bacili

Gram:  Positively staining filamentous branching bacili

-  No evidence of malignancy seen.

Case Discussion

The chest X ray findings are stable for 8 years. It is a microbiology finding.

PlayAdd to Share

Case Information

rID: 38716
Case created: 30th Jul 2015
Last edited: 25th Feb 2016
System: Chest
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.