TORAKS DUVARINA İNVAZE BİR PULMONER AKTİNOMİKOZ: OLGU SUNUMU
Pulmoner aktinomikoz tanısı klinik pratikte hala önemli bir sorundur. Otuz yıldır anti diyabetik tedavi kullanan 64 yaşındaki bayan hasta 2 aydır süre gelen öksürük, sol yan ağrısı, ateş yüksekliği yakınmaları ile kliniğimize başvurdu. Akciğer grafisinde sol akciğer alt zonda homojen dansite artışı izlendi. Toraks Bilgisayarlı tomografisinde sol akciğer linguler segment düzeyinde 3 santimetre boyutunda yumuşak doku lezyonu, plevrada kalınla şma saptandı. Fiberoptik bronkoskopik inceleme ve transbronşial biyopsi tanısal değildi. Tanısal amaçlı torakotomi ile hastaya pulmoner aktinomikoz tanısı kondu. Bu yazıda malignite şüphesi olan hastaların ayırıcı tanısında pulmoner aktinomikozun da bulunması gerektiği ve tanıya ulaşmanın zorlukları vurgulanmıştır.
A PULMONARY ACTINOMYCOSIS INVOLVING TO THE CHEST WALL: A CASE REPORT
The diagnosis of pulmonary actinomycosis is still a difficult problem in medical practice. A 64 year old female who had been using antidiyabetic drugs for 30 years was admitted to our hospital with complaints of cough, fever of two months duration. Chest radiography showed a lesion on the left hemithorax. Thorax CT revealed a soft tissue lesion in the left hemithorax of linguler segmentation which was dimension 3 cm and pleural thickness. Fiberoptic bronchoscopic examination and transbronchial biopsy were not diagnostic. The patient was diagnosed as pulmonary actinomycosis after diagnostic thoracotomy. In the present report, we concluded that pulmonary actinomycosis must be kept in mind in the differential diagnosis of the patients with the radiological findings of malignancy and also diffuculty of the diagnosis was emphasized.
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