An incidental finding of a lung lesion in a patient with systemic sclerosis

Abstract

We present the case of a 59-year-old lady, who was found to have an incidental finding of a lung lesion on a CxR following percutaneous endoscopic gastroscopy tube insertion. Subsequently a computerised tomography scan was performed which suggested primary lung malignancy and CT guided biopsy was arranged. Pathological analysis revealed actinomycosis infection. We discuss the clinical, radiological and pathological findings in actinomycosis and how it can often be mistaken for lung cancer. This may put patients at risk of unnecessary morbidity or even unwarranted surgery and therefore clinicians should have a high clinical suspicion of thoracic actinomycosis, especially if a patient has underlying risk factors, such as aspiration.