(fig 1). Fibreoptic bronchoscopy showed a friable, necrotic mass in the left lower lobe bronchus (fig 2A). Microscopic examination of the biopsy specimen showed sulphur granules with Gram positive filaments highly suggestive of actinomycosis ( fig 2B). As the finding was unexpected bronchoscopy was repeated one week later to confirm the diagnosis before antibiotics were started. At this time the endobronchial mass in the left lower lung was no longer present. Instead there was lumpy oedematous mucosa in the basal segments of the left lower lobe bronchus. Biopsy specimens of these mucosal lesions showed chronic inflammation but no malignancy. Anaerobic culture of the biopsy specimens was also negative. The patient was treated with oral penicillin and probenecid for one year. Bronchoscopy was repeated four months after initiation of treatment and showed a completely normal bronchial tree with no mass or mucosal oedema in the left lower lobe bronchus. At a follow up visit one year after completion of the antibiotics the patient was well and his chest radiograph was normal.

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