title: [Tumor-bronchial actinomycosis simulating a recurrence of lung cancer 14 years after initial treatment: A case report].
abstract: A patient with a history of squamous cell carcinoma of the right upper lung lobe treated 14 years before by concomitant chemo-radiotherapy was referred on account of dyspnea. Bronchial endoscopy revealed complete obstruction of the right main bronchus highly suggestive of a tumor recurrence. However, biopsy samples only showed inflammatory and necrotic tissue with no evidence of malignancy. Despite complete tissue resection by rigid bronchoscopy, a rapid and complete recurrence occurred requiring the placement of a Y-shaped bronchial prosthesis. Repeat histological, bacteriological and mycological analyses were negative. The patient was soon readmitted to hospital for a lung infection due to recurrence of obstruction inside and around the prosthesis. Bacterial examination of biopsy samples identified Actinomyces meyeri. Appropriate antibiotic therapy led to a complete regression of the bronchial obstruction. Unfortunately, the patient died a few months later due to massive hemoptysis after the removal of the prosthesis. Autopsy examination showed a fistula between the right main bronchus and pulmonary artery, with no evidence of neoplastic recurrence nor the persistence of lesions associated with actinomycosis.
authors.affiliation: Service des maladies infectieuses et tropicales, CHU Croix-Rousse, 69004 Lyon, France; Service d'oto-rhino-laryngologie et chirurgie cervico-faciale, CHU Croix-Rousse, 69004 Lyon, France; Service d'anatomie et cytologie pathologiques, CHU Croix-Rousse, Lyon, France; Centre de biologie et de pathologie Nord, CHU Croix-Rousse, 69004 Lyon, France; Service de pneumologie, CHU Croix-Rousse, 69004 Lyon, France. Electronic address: laure073@hotmail.fr.
authors.forename: L
authors.initials: L
authors.lastname: Folliet
authors.affiliation: Service des maladies infectieuses et tropicales, CHU Croix-Rousse, 69004 Lyon, France.
authors.forename: T
authors.initials: T
authors.lastname: Perpoint
authors.affiliation: Service d'oto-rhino-laryngologie et chirurgie cervico-faciale, CHU Croix-Rousse, 69004 Lyon, France.
authors.forename: J-C
authors.initials: JC
authors.lastname: Pignat
authors.affiliation: Service d'anatomie et cytologie pathologiques, CHU Croix-Rousse, Lyon, France.
authors.forename: F
authors.initials: F
authors.lastname: Laurent
authors.affiliation: Centre de biologie et de pathologie Nord, CHU Croix-Rousse, 69004 Lyon, France.
authors.forename: M
authors.initials: M
authors.lastname: Devouassoux
authors.affiliation: Service de pneumologie, CHU Croix-Rousse, 69004 Lyon, France.
authors.forename: M
authors.initials: M
authors.lastname: Perol
authors.affiliation: Service de pneumologie, CHU Croix-Rousse, 69004 Lyon, France.
authors.forename: P
authors.initials: P
authors.lastname: Nesme
authors.affiliation: Service de pneumologie, CHU Croix-Rousse, 69004 Lyon, France.
authors.forename: J-C
authors.initials: JC
authors.lastname: Guerin
authors.affiliation: Service de pneumologie, CHU Croix-Rousse, 69004 Lyon, France.
authors.forename: S
authors.initials: S
authors.lastname: Ernesto
authors.affiliation: Service de pneumologie, CHU Croix-Rousse, 69004 Lyon, France.
authors.forename: L
authors.initials: L
authors.lastname: Odier
authors.affiliation: Service de pneumologie, CHU Croix-Rousse, 69004 Lyon, France.
authors.forename: D
authors.initials: D
authors.lastname: Arpin
mesh_terms: D000196:Actinomycosis / Q000175:diagnosis*; D000368:Aged; D000402:Airway Obstruction / Q000209:etiology / Q000601:surgery; D001706:Biopsy; D001983:Bronchial Fistula / Q000209:etiology; D001999:Bronchoscopy; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000628:therapy; D059248:Chemoradiotherapy; D020878:Device Removal / Q000009:adverse effects; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006469:Hemoptysis / Q000209:etiology; D006801:Humans; D008172:Lung Diseases, Fungal / Q000175:diagnosis*; D008175:Lung Neoplasms / Q000175:diagnosis / Q000628:therapy; D008297:Male; D009336:Necrosis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D011183:Postoperative Complications / Q000209:etiology; D019919:Prosthesis Implantation; D011651:Pulmonary Artery; D013997:Time Factors; D016157:Vascular Fistula / Q000209:etiology
keywords: Actinomyces; Actinomycose endobronchique; Cancer pulmonaire; Endobronchial actinomycosis; Hemoptysis; Hémoptysie; Lung cancer; Radiothérapie thoracique; Thoracic radiotherapy