A Case of Primary Hepatic Actinomycosis after Pancreatoduodenectomy

Hiroshi Kusanagi, Nobuyasu Kano, Shigetoshi Yamada, Kazunori Kasama and Takashi Sakuma

Department of Surgery, Kameda General Hospital

We report rate case of primary hepatic actinomycosis. A 52-year-old man had undergone pancreatoduodenectomy for carcinoma of the ampulla of Vater 4 years earlier. He was admitted to our hospital for detailed examination of a small nodular lesion in the liver. Abdominal ultrasonography revealed a hypoechoic lesion, 2.0 cm in diameter, in S6. A CT scan showed a low density area. T1 weighted MRI revealed a homogenous hypointense lesion. T2 weighted MRI revealed an isointense internal nodule surrounded by a hyperintense peripheral rim. A celiac arteriogram of the lesion showed no definite nodular staining. The posterior segment was partially resected under the suspicion of metastatic tumor. Histological findings revealed abscess-forming inflammation with fibrosis, in which radiating granules were found. There was no evidence of malignancy.

Key words
hepatic actinomycosis, actinomycosis

Reprint requests
Hiroshi Kusanagi Department of Surgery, Kameda General Hospital 929 Higashi-cho, Kamogawa city, 296-8602 JAPAN

Accepted
November 13, 1998

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