CT findings of pulmonary actinomycosis and causes of misdiagnosis / 中华放射学杂志

ABSTRACT

Objective To scrutinize the CT features of pulmonary actinomycosis and analysize the causes of misdiagnosis.Methods CT images of eleven patients with pulmonary actinomycosis proved by pathology were retrospectively reviewed.Among them,6 were scanned with additional enhanced CT scan.Results Among the 11 patients,the lesions located in the inferior lobe in 7 patients,and in the superior lobe in 4 patients.The lesions affected two or more pulmonary segments in 9 patients,6 of them involving two lobes.Irregular mass or nodules with necrotic low-attenuation areas were the main signs in all patients,and segmental consolidations were found in 6 patients.Peripherally progressive enhancement was found in all patients with contrast enhanced CT scan.Vicinity pleural thickening was found in 11 patients,while extrapleural fat deposition was found in 6 patients.One case showed erosion of the chest wall and rib.Conclusion Pulmonary actinomycosis is a chronic suppurative granulomatous inflammation,which is often misdiagnosed with neoplasm or other lung disease because of its mass-like performance.The peripherally progressive enhancement on CT has a certain diagnostic value for P\pulmonary actinomycosis.