A Young Man With Two Large Lung Masses

A Mass Shadow on Chest X-Ray in a 40-Year-Old Man: What’s Your Diagnosis?

“…The average duration of illness before diagnosis is six months [3,4]. The characteristic findings on chest radiography and CT scan include airspace consolidation involving the upper lobe, mild enlargement of mediastinal lymph nodes, and mild pleural thickening adjacent to the airspace consolidation [6]. The following typical clinical and radiographic features were present in our patient.…”

“…Nevertheless, even when the clinical suspicion is high, pulmonary actinomycosis can resemble a spectrum of lung pathologies mainly lung abscess, tuberculosis and malignancy because of similar chronic symptoms and radiographic findings [3,6].…”

“…Diagnosis of actinomycosis is generally hampered by the difficulty in isolation of the bacterium [6]. Hence, lung biopsy is usually necessary to obtain samples for histological and microbiological confirmation of pulmonary actinomycosis [3].…”

“…Sulfur granules, long regarded as a histological hallmark of actinomycosis, are very strongly suggestive of the diagnosis. These are conglomerate organisms that have basophilic masses with radiating rosette of eosinophilic clubs on the surface [6]. However, they are not entirely specific to actinomycosis, since these granules can also be found in nocardiosis and aspergillosis [7].…”

Lung, Pleural and Colon Actinomycosis in an Immunocompromised Patient: A Rare Form of Presentation

“…Actinomycosis has been called 'the most misdiagnosed disease', and it has been reported that 'no disease is so often missed by experienced clinicians'. The disease resembles tuberculosis or lung carcinoma in its thoracic clinical syndrome, which usually follows aspiration and/or is associated with poor dental hygiene or peridental disease [1,2]. These data were absent in the patient.…”