A Case of Pelvic Actinomycosis with Hepatic Actinomycotic Pseudotumor

Kim, Hee Seoung; Park, Noh Hyun; Park, Keoung Ah; Kang, Soon Beom

doi:10.1159/000100058

Cited by 25 publications

(22 citation statements)

References 6 publications

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“…Inflammatory masses, solitary metastatic lesions, and primary liver masses can have the same appearance on CT examination as in our case [7]. Conversely, pelvic actinomycosis in women with intrauterine devices (IUDs) may be associated with inflammatory hepatic pseudotumors [7,8].…”

Section: Discussionsupporting

confidence: 52%

“…Among 35 previously reported isolated hepatic actinomycosis cases, predisposing factors included poor dentition in five patients, alcohol abuse in three, biliary tract disease in two, recent appendicitis in two, peptic ulcer in two, and oral neoplasm in one [6]. Hepatic actinomycotic tumor was also reported to occur with pelvic actinomycosis in women using intrauterine device [7]. Nevertheless, the majority of the cases are cryptogenic, as suggested by Sharma et al [5,6].…”

Section: Discussionmentioning

confidence: 87%

“…Conversely, pelvic actinomycosis in women with intrauterine devices (IUDs) may be associated with inflammatory hepatic pseudotumors [7,8]. Considering the clinical features and the enhancement pattern of the mass at imaging studies, we were able to exclude hemangioma, focal nodular hyperplasia, and adenoma from the differential diagnosis list.…”

Section: Discussionmentioning

confidence: 99%

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Actinomycotic hepatic abscess

et al. 2007

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Actinomycotic hepatic abscess was diagnosed in a 46-year-old male driver from Ukraine presenting with the symptoms of malaise, loss of appetite, upper right quadrant pain, weight loss, and night sweats which had been present for last 2 months. Computed tomography (CT) of the abdomen revealed a hypodense mass in the left liver lobe which was suspected as hepatocellular carcinoma. Histopathological examination of the CT guided biopsy specimen yielded a diagnosis of actinomycotic abscess of the liver. Treatment with intravenous penicillin for 6 weeks followed by a course of oral penicillin for 14 weeks resulted in complete cure as evidenced by clinical improvement and radiological disappearance of the lesion.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

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Actinomycotic hepatic abscess

et al. 2007

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“…CT often demonstrates multiloculated spaces occupying hypoattenuated lesions making a differential diagnosis of echinococcosis, amoebiasis, multiple pyogenic abscess and cystic neoplasm [4]. MRI is characterized by low-signal intensity on T1 and high-signal intensity on T2 weighted images [9]. …”

Section: Discussionmentioning

confidence: 99%

Isolated hepatic actinomycosis: a case report

2010

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IntroductionActinomyces are slow growing, non-spore forming, gram-positive, branching bacilli that thrive in anaerobic and microareophilic conditions. Actinomyces are more commonly associated with oral and cervicofacial infections. Hepatic involvement in infections of the abdomen (known as isolated hepatic actinomycosis) is rare, accounting for only 5% of all cases of actinomycosis.Case presentationWe present the case of a 75-year-old Caucasian woman with a 3-month history of night sweats, fever, chills, abdominal bloating, anorexia, weight-loss, and early satiety. The patient was found to have isolated hepatic actinomycosis infection after undergoing a laparotomy with a biopsy of the liver. The patient has now recovered.ConclusionIsolated hepatic actinomycosis is a rare and often overlooked etiology for a liver mass. Given its subacute presentation and nondescript symptomatology, physicians should be aware of this differential and the potential pitfalls in diagnosis and management.

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“…Only a few cases of hepatic actinomycosis diagnosed by FNA have been reported [22,23,24,25,26,27,28]. Review of these published cases shows that afflicted patients presented with either single or multiple hepatic masses.…”

Section: Discussionmentioning

confidence: 99%

Cytopathology of Hepatobiliary-Related Actinomycosis

Xing

Rodrı́guez²,

Pantanowitz

2016

Acta Cytologica

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Background: The clinical diagnosis of hepatobiliary-related actinomycosis can be challenging owing to its rarity and variable presentation. Moreover, actinomycotic pseudotumors may mimic malignancy and result in unnecessary surgical resection. Herein, we present the clinical and cytopathological features of 3 cases with hepatobiliary-related actinomycosis. Cases: The first patient was a 73-year-old man who presented with an exophytic liver lesion. The second patient was a 78-year-old woman who presented with a biliary stricture. The third patient was an 88-year-old woman with a right flank mass extending to the liver. The aspirate smears in these 3 cases demonstrated ‘cotton ball' clusters of filamentous microorganisms and abscesses. The cell blocks of 2 of the patients showed sulfur granules with peripheral filamentous microorganisms positive with a Gram stain but negative with an acid fast stain, consistent with Actinomyces species. All patients were elderly and shared a past surgical history of laparoscopic cholecystectomy. Conclusion: These casesdemonstrate the complementary role of cytology in the diagnosis of hepatobiliary actinomycosis. A cytologic diagnosis of actinomycosis is minimally invasive and quick. It can prompt proper culture medium selection and avoid unnecessary or extensive surgery. Based on our experience, laparoscopic cholecystectomy may be a precipitating factor for the subsequent development of hepatobiliary-related actinomycosis.

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A Case of Pelvic Actinomycosis with Hepatic Actinomycotic Pseudotumor

Cited by 25 publications

References 6 publications

Actinomycotic hepatic abscess

Actinomycotic hepatic abscess

Isolated hepatic actinomycosis: a case report

Cytopathology of Hepatobiliary-Related Actinomycosis

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