A CASE OF ACTINOMYCOSIS OF THE SIGMOID COLON DIAGNOSED AS MALIGNANT DISEASE PREOPERATIVELY

Abstract

A case of abdominal actinomycosis which was diagnosed as malignant disease preoperatively is reported. A 61-year-old man had a palpable tumor in the left lower quadrant of the abdomen. Barium enema showed an irregular stenotic lesion of the sigmoid colon, and thereafter, he suffered from obstructive symptoms. Under a preoperative diagnosis of diffuse infiltrative carcinoma or metastatic carcinoma of the sigmoid colon, an operation was performed in the same way as malignant disease. Light microscopic examination of the resected tissues revealed abdominal actinomycosis, showing sulfur granules in the abscess. Abdominal actinomycosis is chronic suppurative granulomatous infection caused by Actinomyces which forms a part of the normal flor of the human mouth and gastrointestinal tract. To make the preoperative diagnosis for the disease is extremely difficult. It is important to bear in mind this disease as a probable diagnosis when the abdominal tumor is encountered. In histopathological examination, we should cut the surgical specimen into a lot of pieces in order to demonstrate sulfur granules.