CTICasesAirway-Centered Pulmonary Actinomycosis
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Imaging findings
Chest CT demonstrates a mass-like area of consolidation in the right lower lobe showing a tubular configuration and adjacent lobular air trapping. Small surrounding satellite nodules are present, suggesting an airway-centered inflammatory process. Subsequent PET/CT demonstrates non-specific fluorodeoxyglucose hypermetabolic activity within the consolidation.
Key takeaways
Actinomyces odontolyticus is a commensal oral pathogen that can cause aspiration-related pulmonary infection, particularly in patients with poor dentition. When airway-centered, it can mimic bronchogenic carcinoma on imaging and PET/CT. Bronchoalveolar lavage or biopsy is valuable in avoiding unnecessary lung resections, as the infection responds well to penicillin.
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