Sato T, Takada N, Dobashi Y, Suzuki M, Ouchi M, Abe Y
Department of Respiratory Medicine, International Goodwill Hospital, Kanagawa, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1997 Aug;35(8):888-93.
A 25-year-old, previously healthy man was referred to us because of fever, left-sided chest pain, and an abnormal mass shadow at the left pulmonary hilum on chest X-ray films. Laboratory tests and fiberoptic bronchoscopy revealed no abnormality. Thoracotomy was done because a mediastinal tumor was suspected. Surgery revealed that the left lingula was atelectatic and that the mass was in the left S4, not in the mediastinum. Pathological examination of tissue from the partially resected lung showed sulfur granules, and a diagnosis of pulmonary actinomycosis was made. At least 80 cases of pulmonary actinomycosis were reported in Japan between 1963 and 1995. Pulmonary actinomycosis is most common among men in the fifth and sixth decades of life, and almost all patients have oral disease. Pulmonary actinomycosis is often difficult to distinguish from lung cancer, because both appear as mass shadows on X-ray films, and almost all cases of pulmonary actinomycosis are diagnosed by thoracotomy.
一名25岁、既往健康的男性因发热、左侧胸痛以及胸部X线片显示左肺门有异常肿块阴影而被转诊至我院。实验室检查和纤维支气管镜检查均未发现异常。由于怀疑有纵隔肿瘤，遂进行了开胸手术。手术发现左舌叶肺不张，肿块位于左肺上叶前段（S4），而非纵隔。对部分切除的肺组织进行病理检查发现了硫黄颗粒，确诊为肺放线菌病。1963年至1995年间，日本至少报告了80例肺放线菌病病例。肺放线菌病在50至60岁男性中最为常见，几乎所有患者都有口腔疾病。肺放线菌病常常难以与肺癌区分，因为两者在X线片上均表现为肿块阴影，并且几乎所有肺放线菌病病例都是通过开胸手术确诊的。
