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Pulmonary actinomycosis appearing as a "ball-in-hole" on chest radiography and bronchoscopy.
  1. M. J. Hsieh,
  2. W. B. Shieh,
  3. K. S. Chen,
  4. T. J. Yu,
  5. H. P. Kuo,
  6. Y. H. Tsai
  1. Department of Thoracic Medicine, Chang-Gung Memorial Hospital, Keelung, Taiwan.


    A 40 year old diabetic man with pulmonary actinomycosis was admitted to hospital with recurrent haemoptysis. The chest radiograph showed an air meniscus in the left upper lobe, a rare presentation of pulmonary actinomycosis. Bronchoscopic examination revealed a mass in a cavity which has never been reported previously. He underwent lobectomy and the surgical specimen revealed sulphur granules, the typical pathological finding of actinomycosis, without evidence of fungal or mycobacterial infection.

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