Majid MILANI, Mohammed Hossein Rahimi RAD

Primary endobronchial actinomycosis simulating endobronchial tuberculosis in a patient with diabetes mellitus

Primer endobronşiyal aktinomikozis nadirdir ve yabancı cisim aspirasyonu olmaksızın son derece beklenmedik bir durumdur. Yetmiş yaşında sigara içmeyen kadın hasta hemoptizi ve iki aydır kilo kaybı yakınmalarıyla başvurdu. Bilgisayarlı tomografide hiler kitle olması nedeniyle bronş kanseri ön tanısıyla fiberoptik bronkoskopi yapıldı. Sol üst lob bronşunda vejetasyon saptandı. Biyopsi örneğinin histolojik incelemesi aktinomiçes infeksiyonu olduğunu gösterdi. Hasta penisilin tedavisine yanıt verdi ve akciğer grafisi dört ayda tamamen düzeldi. Yabancı cisim varlığı olmaksızın diabetes mellitusla endobronşiyal aktinomikozis birlikteliği daha önce bildirilmemiştir ve endobronşiyal tüberküloz veya kanserde endobronşiyal vejetasyonların ayırıcı tanısına dahil edilmelidir.

Diabetes mellitusu olan hastada endobronşiyal tüberkülozu taklit eden primer endobronşiyal aktinomikozis

Primary endobronchial actinomycosis is rare and very uncommon without foreign body aspiration. A 70-years old nonsmoker diabetic woman was presented with hemoptysis and weight loss for two months. Fiberoptic bronchoscopy was performed because of hilar mass on her computerized tomography scan, with a presumptive diagnosis of bronchial carcinoma. It demonstrated vegetations in left upper lobe bronchus. Histologic examination of the biopsy specimen demonstrated Actinomyces infection. The patient responded well to penicillin therapy and chest X-ray completely cleared in four months. To our knowledge, the association of endobronchial actinomycosis with diabetes mellitus without presence of a foreign body has not been reported previously, and should be included in differential diagnosis with endobronchial tuberculosis or cancer in endobronchial vegetations.

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