Lee C M, Ng S H, Wan Y L, Tsai C H
Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC.
J Formos Med Assoc. 1996 Jan;95(1):66-8.
A case of actinomycosis of the stomach in a 61-year-old woman is reported. The patient presented to the hospital with a history of epigastric pain, fatigue, poor appetite, constipation and mild fever of 20 days' duration. On physical examination, a tender mass was felt at the epigastrium. Computed tomography (CT) showed a heterogeneously enhanced mass at the posterior wall of the stomach. Upper gastrointestinal series revealed a submucosal mass at the gastric antrum. A malignant tumor was suspected and surgery was recommended. A 5 x 4 x 2 cm mass was found at the posterior wall of the distal gastric antrum. A Billroth II subtotal gastrectomy was performed. Pathologic examination revealed suppuration and sulfur granules in the indurated mass. The patient was subsequently treated with intravenous penicillin-V for 12 days and then with oral penicillin-G for 4 months. She remained well at her last follow-up appointment. Although the initial radiologic findings were nonspecific, CT was of importance in delineating the location and evaluating the extent of the lesion.
报告了一例61岁女性胃放线菌病病例。该患者因上腹部疼痛、乏力、食欲减退、便秘及持续20天的低热入院。体格检查时，上腹部可触及一压痛性肿块。计算机断层扫描（CT）显示胃后壁有一不均匀强化肿块。上消化道造影显示胃窦部有一黏膜下肿块。怀疑为恶性肿瘤，建议手术治疗。在胃远端窦后壁发现一个5×4×2 cm的肿块。实施了毕罗Ⅱ式胃大部切除术。病理检查显示硬结肿块中有化脓及硫磺颗粒。患者随后静脉注射青霉素V 12天，然后口服青霉素G 4个月。在最后一次随访时她情况良好。尽管最初的影像学表现不具特异性，但CT对于明确病变位置及评估病变范围很重要。
