title: Primary vesical actinomycosis: a case diagnosed by multiple transabdominal needle biopsies.
abstract: Primary vesical actinomycosis is an extremely rare disease. In most cases it is misdiagnosed as vesical or urachal tumor and usually diagnosed through post-operative pathologic confirmation. Here we report a case of primary vesical actinomycosis confirmed by preoperative repeated multiple transabdominal biopsies. The patient was a 49-yr-old woman who presented with frequency, dysuria, and intermittent gross hematuria for 2 months. Computed tomography and cystoscopic examination showed broad-based, edematous, and protruding mass at the dome and anterior portion of the bladder. The clinical and imaging findings of the patient initially suggested vesical malignancy. Transurethral resection and multiple biopsies of the mass were performed. Pathologic examination demonstrated fibrosis with chronic inflammation. We performed repeated transabdominal multiple needle biopsies for further pathologic confirmation. Histopathologic examination demonstrated typical sulfur granules, which were consistent with actinomycosis.
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Kyoung Rae
authors.initials: KR
authors.lastname: Lee
authors.forename: Young Su
authors.initials: YS
authors.lastname: Ko
authors.forename: Jeong Woo
authors.initials: JW
authors.lastname: Yu
authors.forename: Cheol Yong
authors.initials: CY
authors.lastname: Yoon
authors.forename: Chul Hwan
authors.initials: CH
authors.lastname: Kim
authors.forename: Duck Ki
authors.initials: DK
authors.lastname: Yoon
mesh_terms: D000005:Abdomen; D000196:Actinomycosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D001707:Biopsy, Needle / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use; D016896:Treatment Outcome; D014463:Ultrasonography; D001743:Urinary Bladder / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D001745:Urinary Bladder Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery
chemical_list: D010406:Penicillins