PMC5022073_01
(a) Axial computed tomography image demonstrating a 3 x 2.5 cm chest wall mass with limited surrounding inflammatory changes at the level of the 11th rib and minimal right lower lobe parenchymal changes. (b) Magnetic resonance imaging demonstrating progression of the soft tissue mass from computed tomography obtained 9 days prior. The mass measured 9 x 9 x 4.5 cm, with a central necrosis and fluid collection.
gr1.jpg
PMC5022073_01_gr1.jpg
fig0005
CT of the chest that was performed prior to the physical exam demonstrated a right posterior chest wall mass of 3 x 2.5 cm at the level of the 11th rib, minimal right lower lobe parenchymal changes and no pleural effusion. (Fig. 1a).
(a) Preoperative appearance of chest wall abscess. Central necrotic area with extensive erythema and edema. (b) Immediate postoperative appearance. The surrounding erythema and soft tissue edema are significantly improved.
gr2.jpg
PMC5022073_01_gr2.jpg
fig0010
(a) Six-week follow-up appearance, the wound bed is well granulating, without drainage or persistent of sinus tract. (b) Six-week follow-up axial computed tomography image showing complete resolution of the mass.
gr3.jpg
PMC5022073_01_gr3.jpg
fig0015
Imaging obtained 6 weeks postoperatively demonstrated adequate healing and granulation tissue on the chest wall (Fig. 3a) and complete resolution of the mass on the imaging studies. (Fig. 3b)
Sulfur granule (red arrow) composed of filamentous bacteria consistent with actinomyces in background of neutrophils (black arrow), (hematoxylin-eosin stain, 200x magnification).
gr4.jpg
PMC5022073_01_gr4.jpg
fig0020
Within the abscess, there were granules composed of filamentous bacteria consistent with actinomycosis (Fig. 4).