Pulmonary actinomycosis mimicks lung cancer

A 54-year-old woman presented with complaints of cough, fever, sputum, chest pain, and hemoptysis. Lung cancer was considered after viewing the patient’s positron emission tomography/computed tomography scan (Figure 1). Furthermore, a diagnosis could not be made based on the bronchoscopy and tru-cut biopsy results. Since the patient’s complaints of hemoptysis gradually increased, we performed a left upper lobectomy. Pulmonary actinomycosis was diagnosed as a result of the histopathological evaluation.

FIGURE 1:
F-18 FDG PET/CT scan shows a lesion approximately 53 mm in size (arrow) with irregular borders in the anterior segment of the (A) left lung upper lobe and (B) an increased maximum standardized uptake value of 16.7. F-18 FDG PET/CT, 2-deoxy-2-[fluorine-18] fluoro-D-glucose positron emission tomography/computed tomography.

Pulmonary actinomycosis is a very rare disease that usually occurs in people with poor oral hygiene and can cause serious morbidity and mortality if not treated appropriately. The infection is caused by a form of Actinomyces, an anaerobic bacterium with a progressive course. Pulmonary actinomycosis is difficult to diagnose. Clinically and radiologically, pulmonary actinomycosis can often mimic tuberculosis, lung abscess, or lung cancer^1,2, and can sometimes cause life-threatening recurrent hemoptysis³. Pulmonary actinomycosis is a rare condition that should be considered in the differential diagnosis of lung cancer.

REFERENCES

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  Mabeza GF, Macfarlane J. Pulmonary actinomycosis. Eur Respir J. 2003;21(3):545-51.
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  Karadeniz G, Polat G, Ucsular F, Yalnız E. A difficult disease to diagnose: Pulmonary actinomycosis. Clin Respir J. 2020;14(4):416-8.
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  Suzuki M, Araki K, Matsubayashi S, Kobayashi K, Morino E, Takasaki J, et al. A case of recurrent hemoptysis caused by pulmonary actinomycosis diagnosed using transbronchial lung biopsy after bronchial artery embolism and a brief review of the literature. Ann Transl Med. 2019;7(5):108.

• Financial Support: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publication Dates

• Publication in this collection
  12 Aug 2022
• Date of issue
  2022

History

• Received
  07 Apr 2022
• Accepted
  06 June 2022