A Case of Pulmonary Actinomycosis Diagnosed by Bronchoscopy Using Endobronchial Ultrasonography with a Guide-Sheath Method

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  • Arimura Yasuji
    Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki Division of Data Management, Department of Social Medicine, Faculty of Medicine, University of Miyazaki
  • Kitamura Akiko
    Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki
  • Tsuchida Shinpei
    Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki
  • Matsuo Ayako
    Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki
  • Oda Yasuharu
    Department of Internal Medicine, National Health Insurance Takachiho Town Hospital
  • Tsubouchi Hironobu
    Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki
  • Sakamoto Akihiro
    Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki
  • Imazu Yoshifumi
    Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki
  • Iiboshi Hirotoshi
    Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki
  • Tokojima Masatoshi
    Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki Department of Internal Medicine, Saito Koyu Medical Center
  • Matsumoto Nobuhiro
    Division of Neurology, Respirology, Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki

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  • EBUS-GS法を用いた気管支鏡検査にて診断した肺放線菌症の1例

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<p>Background. The diagnostic rate of pulmonary actinomycosis by bronchoscopy is reportedly low. Case. A 62-year-old woman complained of bloody sputum, which had started three weeks before admission to a neighborhood hospital. Chest computed tomography (CT) indicated a mass in the right upper lobe, and the patient was referred to another hospital. Bronchoscopy was performed but was not contributory in making a diagnosis. The bloody sputum persisted and the mass on CT enlarged. She was then referred to our hospital. She had untreated dental caries and diabetes. CT revealed a mass with central low attenuation areas, raising the possibility of pulmonary actinomycosis in the differential diagnosis. To collect a specimen from the central part of the mass, bronchoscopy using endobronchial ultrasonography with a guide-sheath (EBUS-GS) method was performed. Brushing cytology revealed sulfur granules characteristic of actinomycosis. Conclusions. The suspicion of pulmonary actinomycosis necessitated collection of a specimen from the deep part of the lesion. Bronchoscopy by the EBUS-GS method was useful for making the diagnosis.</p>

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