Actinomycosis mimicking malignancy: a report of three cases diagnosed with fine-needle aspiration cytology.

Q2 Medicine Infezioni in Medicina Pub Date : 2022-09-01 eCollection Date: 2022-01-01 DOI:10.53854/liim-3003-16
Pasquale Cretella, Maria Carola Italia, Bianca Serio, Pio Zeppa, Alessandro Caputo
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引用次数: 1

Abstract

We describe three cases of actinomycosis of the head and neck area, clinically suspected to be malignancies, diagnosed by fine-needle aspiration (FNAC). The patients presented with painless, slowly growing masses in the cervicofacial area. Ultrasonography identified the masses as enlarged lymph nodes which were subsequently biopsied by FNAC. Cytological features were similar in all cases, with a background of granulocytes and scattered lymphocytes and histiocytes. At high magnification colonies of branching, filamentous and beaded bacteria were detected. In the Diff-Quik-stained smears, these filamentous colonies showed an evident yellowish color with the typical feature of the "sulfur granules" consistent with the Splendore-Hoeppli phenomenon. A diagnosis of actinomycosis was made and confirmed in all cases by the subsequent microbiological tests. The patients were treated with high-dose penicillin, which caused the masses to progressively shrink. The lymph nodal localization of cervico-facial actinomycosis may be a diagnostic challenge, because in that area, lymphadenopathies may occur both in benign and malignant conditions. FNAC is a safe, fast, and reliable method to perform an accurate diagnosis of actinomycosis avoiding the surgical excision for histological evaluation.

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模拟恶性放线菌病:细针穿刺细胞学诊断3例报告。
我们描述3例放线菌病的头颈部,临床怀疑是恶性肿瘤,诊断细针抽吸(FNAC)。患者表现为颈部面部无痛、缓慢生长的肿块。超声检查发现肿块为肿大的淋巴结,随后行FNAC活检。所有病例的细胞学特征相似,以粒细胞为背景,散在淋巴细胞和组织细胞。在高倍镜下检测到分枝菌、丝状菌和珠状菌菌落。在diff - quik染色涂片中,这些丝状菌落显示出明显的淡黄色,具有与Splendore-Hoeppli现象一致的“硫颗粒”的典型特征。所有病例均经随后的微生物试验确诊为放线菌病。患者接受大剂量青霉素治疗,使肿块逐渐缩小。颈部-面部放线菌病的淋巴结定位可能是一个诊断挑战,因为在该区域,淋巴结病变可能发生在良性和恶性的情况下。FNAC是一种安全、快速、可靠的准确诊断放线菌病的方法,避免了手术切除进行组织学评估。
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来源期刊
Infezioni in Medicina
Infezioni in Medicina Medicine-Infectious Diseases
CiteScore
8.40
自引率
0.00%
发文量
62
期刊介绍: The Journal publishes original papers, in Italian or in English, on topics concerning aetiopathogenesis, prevention, epidemiology, diagnosis, clinical features and therapy of infections, whose acceptance is subject to the referee’s assessment. The Journal is of interest not only to infectious disease specialists, microbiologists and pharmacologists, but also to internal medicine specialists, paediatricians, pneumologists, and to surgeons as well. The Editorial Board includes experts in each of the above mentioned fields.
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