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DOI:10.2214/AJR.04.1749
AJR 2006; 186:225-231
© American Roentgen Ray Society

Pictorial Essay

Thoracic Actinomycosis: CT Features with Histopathologic Correlation

Tae Sung Kim1, Joungho Han2, Won-Jung Koh3, Jae Chol Choi3, Myung Jin Chung1, Ju Hyun Lee1, Sung Shine Shim1 and Semin Chong1

1 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul 135-710, South Korea.
2 Department of Diagnostic Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-dong, Gangnam-gu, Seoul 135-710, South Korea.
3 Department of Medicine, Division of Pulmonary and Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul 135-710, South Korea.

OBJECTIVE. Thoracic actinomycosis is a chronic suppurative pulmonary or endobronchial infection caused by Actinomyces israelii, a gram-positive anaerobic organism. We present the CT features of thoracic actinomycosis with histopathologic correlation.

CONCLUSION. The typical CT feature of parenchymal actinomycosis is a chronic segmental air-space consolidation containing necrotic low-attenuation areas with frequent cavity formation. A broncholith can be secondarily infected with Actinomyces organisms, resulting in endobronchial actinomycosis. It usually manifests as a proximal endobronchial calcification associated with distal obstructive pneumonia.

Keywords: broncholithiasis • CT • endobronchial actinomycosis • thoracic actinomycosis


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