Primary Endobronchial Actinomycosis Simulating Bronchial Carcinoma in a Patient with Stroke

A 65-year-old hemiplegic man was presented with cough and dyspnea for five months. Fiberoptic bronchoscopy was performed because of hilar mass on his CT scan, with a presumptive diagnosis of bronchial carcinoma. Flexible bronchoscopy demonstrated an obstructing yel­lowish mass on intermediate bronchus. Histologic examination of the biopsy specimen demonstrated Actinomyces infection. The patient re­sponded well to penicillin therapy, and endobronchial lesion resolved completely in three months. To our knowledge, the association of endobronchial actinomycosis with cerebrovascular disease has not been reported previously, and should be suspected in patients with neurological deficit with tendency to aspiration.