흉부방선균증은 임상양상 및 방사선학적 소견이 폐의 기타 염증성 질환이나 악성암과 유사한 경우가 많아 감별진단에서 놓치기 쉬우나, 대부분 항생제 치료에 좋은 반응을 보이므로 조기진단을 위한 적극적 접근으로 심각한 합병증의 발생 및 불필요한 수술을 막아야 한다. 저자들은 폐암을 의심하여 시행한 검사도중 폐를 침범하는 방선균증을 경험하였기에 문헌고찰과 함께 보고하는 바이다.
A 75 year old woman was admitted for evaluation of right lung mass. She was not a smoker. She had been diagnosed as uterine prolapse and during preoperative assessment a lung mass was found incidentally on simple chest X-ray. On chest CT scan, $3.5{ imes}2$ cm sized homogeneous mass was located in the anterior segment of right upper lobe and there were multiple calcified lymph nodes in both hilum and mediastinal area. We performed diagnostic bronchoscopy, but no definite endobronchial mass was found. Next we did CT guided percutaneous fine needle aspiration biopsy. On microscopy, sulfur granules consisting of multiple granular basophilic centers with hyaline projection of branching filaments were noted. From this finding we made a diagnosis of pulmonary actinomycosis.
