Pulmonary actinomycosis mimicking a lung metastasis from esophageal cancer; a case report

• Published in: BMC pulmonary medicine Vol. 18; no. 1; p. 39
• Main Authors: Nagao, Munemasa, Fukuda, Akihisa, Matsumura, Takeshi, Kimura, Toshiyuki, Seno, Hiroshi
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 27-02-2018; BioMed Central; BMC
• Subjects: Actinomycosis; Actinomycosis - diagnosis; Actinomycosis - pathology; Aged; Biopsy, Needle; Case Report; CAT scans; Development and progression; Diagnosis; Diagnosis, Differential; Endoscopy, Digestive System; Esophageal cancer; Esophageal Neoplasms - complications; Esophageal Neoplasms - diagnosis; Esophageal Neoplasms - therapy; Fluorodeoxyglucose F18; Health aspects; Humans; Infection; Lung cancer; Lung Neoplasms; Male; Neoplasm Metastasis; Pleural Effusion - etiology; Pleural Effusion - pathology; Pneumonia, Bacterial - diagnostic imaging; Positron Emission Tomography Computed Tomography; Infection; Actinomycosis; Esophageal cancer
• ISSN: 1471-2466; 1471-2466
• DOI: 10.1186/s12890-018-0602-z

Actinomycosis is a rare bacterial infection caused by Actinomyces. The symptom of actinomycosis is nonspecific and radiological images present as a slow-progressive mass lesion similarly to malignancies. Thus, it is difficult to distinguish pulmonary actinomycosis from malignancies.
A 74-year-old male who had esophageal cancer and a pulmonary mass that was positive for
F-fluorodeoxyglucose positron emission tomography/computed tomography was initially diagnosed with esophageal cancer with a lung metastasis because he was asymptomatic. However, aspiration of pleural effusion revealed that the pulmonary lesion was actinomycosis.
We present a case of pulmonary actinomycosis mimicking a lung metastasis from esophageal cancer. Diagnosis of asymptomatic pulmonary actinomycosis is difficult, and needle aspiration could be useful for a definitive diagnosis of pulmonary actinomycosis.