Primary Vesical Actinomycosis: A Case Diagnosed by Multiple Transabdominal Needle Biopsies

• Published in: Journal of Korean medical science Vol. 17; no. 1; pp. 121 - 124
• Main Authors: Lee, Kyoung Rae, Ko, Young Su, Yu, Jeong Woo, Yoon, Cheol Yong, Kim, Chul Hwan, Yoon, Duck Ki
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Academy of Medical Sciences 01.02.2002; 대한의학회
• Subjects: Abdomen; Actinomycosis - diagnostic imaging; Actinomycosis - drug therapy; Actinomycosis - pathology; Actinomycosis - surgery; Biopsy, Needle - methods; Female; Follow-Up Studies; Humans; Middle Aged; Penicillins - therapeutic use; Treatment Outcome; Ultrasonography; Urinary Bladder - diagnostic imaging; Urinary Bladder - pathology; Urinary Bladder - surgery; Urinary Bladder Diseases - diagnostic imaging; Urinary Bladder Diseases - drug therapy; Urinary Bladder Diseases - pathology; Urinary Bladder Diseases - surgery; 의학일반
• ISSN: 1011-8934; 1598-6357
• DOI: 10.3346/jkms.2002.17.1.121

Primary vesical actinomycosis is an extremely rare disease. In most cases it is misdiagnosed as vesical or urachal tumor and usually diagnosed through post-operative pathologic confirmation. Here we report a case of primary vesical actinomycosis confirmed by preoperative repeated multiple transabdominal biopsies. The patient was a 49-yr-old woman who presented with frequency, dysuria, and intermittent gross hematuria for 2 months. Computed tomography and cystoscopic examination showed broad-based, edematous, and protruding mass at the dome and anterior portion of the bladder. The clinical and imaging findings of the patient initially suggested vesical malignancy. Transurethral resection and multiple biopsies of the mass were performed. Pathologic examination demonstrated fibrosis with chronic inflammation. We performed repeated transabdominal multiple needle biopsies for further pathologic confirmation. Histopathologic examination demonstrated typical sulfur granules, which were consistent with actinomycosis.