Ha Yeon Jung, An Ji Hyun, Shim Ju Hyun, Yu Eun Sil, Kim Jong Jae, Ha Tae Yong, Lee Han Chu
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Clin Mol Hepatol. 2015 Mar;21(1):80-4. doi: 10.3350/cmh.2015.21.1.80. Epub 2015 Mar 25.
Primary hepatic actinomycosis is one of the chronic abscess-forming infections of the liver. Accurate diagnosis is frequently delayed due to its indolent course and nonspecific clinical and radiological manifestations. We report a case of a 57-year-old man presenting with asymptomatic multiple hepatic masses on follow-up abdominal computed tomography performed 1 year after stomach cancer surgery. Although a percutaneous liver biopsy procedure was conducted twice in order to obtain confirmative pathology, only a nonspecific organizing abscess with plasma cell infiltration was revealed, without identification of any organism in the tissue cultures. Ultimately, actinomycosis was diagnosed following the detection of sulfur granules on open surgical biopsied tissue. This case suggests that primary hepatic actinomycosis should be considered as one of the possible causes for enigmatic inflammatory lesions of the liver.
原发性肝放线菌病是肝脏慢性脓肿形成性感染之一。由于其病程隐匿以及临床和影像学表现不具有特异性，准确诊断常常延迟。我们报告一例57岁男性病例，该患者在胃癌手术后1年进行的腹部计算机断层扫描随访中发现无症状的多发性肝脏肿块。尽管为了获得确诊性病理结果进行了两次经皮肝穿刺活检，但仅发现有浆细胞浸润的非特异性组织化脓肿，组织培养中未发现任何病原体。最终，在开放性手术活检组织中检测到硫颗粒后确诊为放线菌病。该病例提示原发性肝放线菌病应被视为肝脏不明原因炎症性病变的可能原因之一。
