대한흉부영상의학회 Weekly Chest Cases

Diagnosis: Endobronchial actinomycosis associated with foreign body
Radiologic Findings: Chest PA shows subtle nodular opacities in the right lower lobar zone.
Chest CT images show radioopaque linear branching opacity in the right lower lobar and basal segmental bronchi. Associated mucus pluggings with peribronchial GGO and nodules were seen in the right lower lobe. On bronchoscopic exam, there was foreign body with granulation tissue at the entrance of right lower lobar basal bronchus. Bronchoscopic biopsy revealed actinomycosis with chronic active bronchitis.
Brief Review: Endobronchial actinomycosis can be associated with aspirated foreign material, such as a chicken bone, a tooth, a fish bone, a grape seed, or a bean. The bronchial infection results from direct aspiration of foreign body contaminated with Actinomyces organisms. CT may show a radioopaque endobronchial nodule, in cases of an aspirated bone fragment, with distal obstructive pneumonia. Rarely, both the parenchymal form and the endobronchial form can be encountered in one patient.
References: Tae Sung Kim, Joungho Han, Won-Jung Koh, et al. Thoracic Actinomycosis: CT Features with Histopathologic Correlation. American Journal of Roentgenology. 2006;186: 225-231
Keywords: Airway, Infection, Bacterial infection,

- Seirei Hamamatsu General Hospital , Japan Kenichi Mizuki
- Daejin Medical Center Bundang Jesaeng General Hospital , Korea (South) Donghwan Kim
- Diskapi Yildirim Beyazit Hospital, Ankara , Turkey Meric Tuzun
- Fortis hospital , Mohali , India Shaleen Rana
- Seoul national university , Korea (South) Kumju Chae
- Mallinckrodt Institute of Radiology , United States Naganathan Mani
- Pneumologia Universitaria, Policlinico di Bari , Italy Mario Damiani

대한흉부영상의학회 Korean Society of Thoracic Radiology