酷似恶性肿瘤的食管放线菌病

Esophageal Actinomycoses Mimicking Malignancy.

作者信息

Pillappa Raghavendra, O'Brien Thomas F, Sullivan Jennifer L, Weksler Benny

机构信息

Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Methodist University Hospital, Memphis, Tennessee.

Division of Thoracic Surgery, Department of Surgery, University of Tennessee Health Science Center, Methodist University Hospital, Memphis, Tennessee.

出版信息

Ann Thorac Surg. 2016 May;101(5):1967-70. doi: 10.1016/j.athoracsur.2015.07.044.

DOI:10.1016/j.athoracsur.2015.07.044

PMID:27106429

Abstract

Actinomycosis is caused by anaerobic bacteria and rarely affects the esophagus. We present a case of esophageal actinomycosis in a 55-year old woman that mimicked malignancy. The patient presented with dysphagia and weight loss. Preoperative esophagogastroscopic biopsy revealed purulent material, but was inconclusive. Endoscopic ultrasonography suggested esophageal cancer, and chest computed tomography showed a mass in the lower esophagus surrounded by inflammation. The patient underwent esophagogastrectomy, and histopathology examination of the specimen revealed distal esophageal actinomycosis. Preoperative diagnosis of esophageal actinomycosis is difficult, but clinicians should be aware of its unusual presentations and its ability to mimic malignancy.

摘要

放线菌病由厌氧菌引起，很少累及食管。我们报告一例55岁女性食管放线菌病病例，该病例酷似恶性肿瘤。患者表现为吞咽困难和体重减轻。术前食管胃镜活检发现脓性物质，但诊断不明确。内镜超声提示食管癌，胸部计算机断层扫描显示食管下段有一肿块，周围有炎症。患者接受了食管胃切除术，标本的组织病理学检查显示为远端食管放线菌病。食管放线菌病术前诊断困难，但临床医生应意识到其不寻常的表现及其酷似恶性肿瘤的可能性。