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Pulmonary actinomycosis associated with endobronchial vegetable foreign body.

Baek JH, Lee JH, Kim MS, Lee JC - Korean J Thorac Cardiovasc Surg (2014)

Bottom Line: The patient had a history of pulmonary tuberculosis and bronchiectasis.Chest radiography showed consolidation around the nodule in the lateral basal segment of the right lower lobe.We successfully performed a right lower lobectomy.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic and Cardiovascular Surgery, Yeungnam University College of Medicine.

ABSTRACT
A 51-year-old woman visited our hospital with massive hemoptysis. She had suffered from recurrent hemoptysis for five years and had undergone bronchial artery embolization many times. The patient had a history of pulmonary tuberculosis and bronchiectasis. Chest radiography showed consolidation around the nodule in the lateral basal segment of the right lower lobe. We successfully performed a right lower lobectomy. The histological study of the resected specimen showed a vegetable foreign body and clumps of Actinomyces, indicating actinomycosis, which was suggested to be the cause of the hemoptysis. This was a very rare case of hemoptysis caused by a vegetable foreign body and actinomycosis.

No MeSH data available.


Related in: MedlinePlus

(A) The granules are surrounded by a purulent exudate (H&E, ×40). (B) The filaments are clearly visible (H&E, ×400).
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f3-kjtcvs-47-566: (A) The granules are surrounded by a purulent exudate (H&E, ×40). (B) The filaments are clearly visible (H&E, ×400).

Mentions: In December 2011, a 51-year-old woman was admitted to our hospital due to massive hemoptysis. The patient was a nurse. She had suffered from recurrent hemoptysis for five years and had undergone bronchial artery embolization many times. The patient had a history of pulmonary tuberculosis and bronchiectasis. The patient’s vital signs were stable. On chest examination, decreased breathing sound and crackle were audible in the right lower lung field. Laboratory parameters were within normal limits. A chest X-ray showed patchy consolidation in the right lower lung (Fig. 1A). A computed tomography scan of the chest showed a small nodule, ground glass appearance, and consolidation around the nodule in the lateral basal segment of the right lower lobe (Fig. 1B). We performed an operation for the differential diagnosis between the possibility of a malignancy or life-threatening, massive hemoptysis. Under general anesthesia with a double lumen endotracheal tube, we resected the right lower lobe through a posterolateral thoracotomy at the sixth intercostal space. In the operation field, a dense pleural adhesion was observed on the entire surface of the lung. We could palpate a round, hard mass 2.0×3.0 cm in the lateral basal segment of the right lower lobe. The resected specimen consisted of the right lower lobe, weighed 177.5 g, and was sized 11.5×11.2×3.0 cm. On multiple serial sections, a cavity lesion measuring approximately 2.0×2.5 cm was identified (Fig. 2A). Foreign material was identified in the cavity (Fig. 2B). Histopathological examination confirmed it to be a vegetable foreign body, and clumps of Actinomyces, indicating actinomycosis, were present within the abscess cavity (Fig. 3). She was discharged on the twelfth postoperative day without any complications. Two years after surgery, she was healthy and free of recurrence.


Pulmonary actinomycosis associated with endobronchial vegetable foreign body.

Baek JH, Lee JH, Kim MS, Lee JC - Korean J Thorac Cardiovasc Surg (2014)

(A) The granules are surrounded by a purulent exudate (H&E, ×40). (B) The filaments are clearly visible (H&E, ×400).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4279833&req=5

f3-kjtcvs-47-566: (A) The granules are surrounded by a purulent exudate (H&E, ×40). (B) The filaments are clearly visible (H&E, ×400).
Mentions: In December 2011, a 51-year-old woman was admitted to our hospital due to massive hemoptysis. The patient was a nurse. She had suffered from recurrent hemoptysis for five years and had undergone bronchial artery embolization many times. The patient had a history of pulmonary tuberculosis and bronchiectasis. The patient’s vital signs were stable. On chest examination, decreased breathing sound and crackle were audible in the right lower lung field. Laboratory parameters were within normal limits. A chest X-ray showed patchy consolidation in the right lower lung (Fig. 1A). A computed tomography scan of the chest showed a small nodule, ground glass appearance, and consolidation around the nodule in the lateral basal segment of the right lower lobe (Fig. 1B). We performed an operation for the differential diagnosis between the possibility of a malignancy or life-threatening, massive hemoptysis. Under general anesthesia with a double lumen endotracheal tube, we resected the right lower lobe through a posterolateral thoracotomy at the sixth intercostal space. In the operation field, a dense pleural adhesion was observed on the entire surface of the lung. We could palpate a round, hard mass 2.0×3.0 cm in the lateral basal segment of the right lower lobe. The resected specimen consisted of the right lower lobe, weighed 177.5 g, and was sized 11.5×11.2×3.0 cm. On multiple serial sections, a cavity lesion measuring approximately 2.0×2.5 cm was identified (Fig. 2A). Foreign material was identified in the cavity (Fig. 2B). Histopathological examination confirmed it to be a vegetable foreign body, and clumps of Actinomyces, indicating actinomycosis, were present within the abscess cavity (Fig. 3). She was discharged on the twelfth postoperative day without any complications. Two years after surgery, she was healthy and free of recurrence.

Bottom Line: The patient had a history of pulmonary tuberculosis and bronchiectasis.Chest radiography showed consolidation around the nodule in the lateral basal segment of the right lower lobe.We successfully performed a right lower lobectomy.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic and Cardiovascular Surgery, Yeungnam University College of Medicine.

ABSTRACT
A 51-year-old woman visited our hospital with massive hemoptysis. She had suffered from recurrent hemoptysis for five years and had undergone bronchial artery embolization many times. The patient had a history of pulmonary tuberculosis and bronchiectasis. Chest radiography showed consolidation around the nodule in the lateral basal segment of the right lower lobe. We successfully performed a right lower lobectomy. The histological study of the resected specimen showed a vegetable foreign body and clumps of Actinomyces, indicating actinomycosis, which was suggested to be the cause of the hemoptysis. This was a very rare case of hemoptysis caused by a vegetable foreign body and actinomycosis.

No MeSH data available.


Related in: MedlinePlus