PMC545056_01
In abdominal CT scan a large inflammatory tumor like mass is identified. The characteristics of the mass do not indicate colon actinomycosis. The characters of the lesion and the coexisting edema and the severe and diffuse inflammation of the mesentery in the lower right quadrant probably suggest perforated ascending colon tumor.
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F1
Computerized tomography (CT) scans of the abdomen (Figure 1) revealed a soft lobular mass, measuring 5 x 5 cm, attached to the ascending colon and cecum, compatible with a tumor.
The histological examination of the removed specimen (right hemicolectomy specimen) revealed actinomyces colonies in the upper part of the cecum and the ascending colon wall. The large spherical clusters, densely packed and branching, and PAS positive "sulfur granules" are specific of actinomycosis.
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F2
Numerous polymorphonuclear leukocytes within the muscularis and a fibro-purulent reaction over the serosa with actinomycotic "sulfur granules" in it, were found in high power magnification (Figure 2).