ABSTRACT A 40-year-old man presented recurrent cough and bloody sputum for 4 months. Chest X-ray showed a large mass in the right upper lobe. Histopathologic examination of tissue from percutaneous biopsy of the lesion revealed actinomycotic granules and branching filamentous bacteria, and therefore pulmonary actinomycosis was diagnosed. These findings suggest that pulmonary actinomycosis should be included in the differential diagnosis of a mass on a chest X-ray film.
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F. Bellazreg, W. Hachfi, A. Ben Abdelkader, Z. Hattab, N. Kaabia, F. Bahri and A. Letaief, "A Mass Shadow on Chest X-Ray in a 40-Year-Old Man: What’s Your Diagnosis?," Advances in Infectious Diseases, Vol. 2 No. 4, 2012, pp. 148-150. doi: 10.4236/aid.2012.24024.
 J. Moses, G. F. Bonomo, D. E. Wenlund, T. S. Halldorddon and J. P. Connelly, “Actinomyces in Childhood,” Clinical Pediatrics, Vol. 42, No. 2, 1967, pp. 221-226.
 D. Bennhoff, “Actinomycosis: Diagnostic and Therapeutic Considerations and a Review of 32 Cases,” The Laryngoscope, Vol. 94, No. 9, 1984, pp. 1198-1217.
 G. F. Mabeza and J. Macfarlane, “Pulmonary Actinomycosis,” European Respiratory Journal, Vol. 21, No. 3, 2003, pp. 545-551. doi:10.1183/09031936.03.00089103
 M. Kolditz, J. Bickhardt, W. Matthiessen, O. Holotiuk, G. Hoffken and D. Koschel, “Medical Management of Pulmonary Actinomycosis: Data from 49 Consecutive Cases,” Journal of Antimicrobial Chemotherapy, Vol. 63, No. 4, 2009, pp. 839-841. doi:10.1093/jac/dkp016
 S. Chouabe, D. Perdu, G. Deslée, D. Milosevic, E. Marque and F. Lebargy, “Endobronchial Actinomycosis Associated with Foreign Body: Four Cases and a Review of the Literature,” Chest Journal, Vol. 121, No. 6, 2002, pp. 2069-2072. doi:10.1378/chest.121.6.2069
 B. D. Sarodia, C. Farver, S. Erzurum and J. R. Maurer, “A Young Man with Two Large Lung Masses,” Chest Journal, Vol. 116, No. 3, 1999, pp. 814-818.
 N. Shinagawa, E. Yamaguchi, Takahashi and M. Nishimura, “Pulmonary Actinomycosis Followed by Pericarditis and Intractable Pleuritis,” Internal Medicine, Vol. 41, No. 4, 2002, pp. 319-322.
 M. Bennett and Dolin, “Principles and Practice of Infectious Diseases,” 6th Edition, Elsevier, Netherlands, 2005.
 J. C. Choi, W. J. Koh, T. S. Kim, et al., “Optimal Duration of IV and Oral Antibiotics in the Treatment of Thoracic Actinomycosis,” Chest Journal, Vol. 128, No. 4, 2005, pp. 2211-2217. doi:10.1378/chest.128.4.2211