TWO CASES OF THE ABDOMINAL ACTINOMYCOSIS

We report a case of primary actinomycosis of the liver presented with liver abscess and a case of actinomycosis of the cecum which was operated on with a diagnosis of malignant tumor of the colon. Case 1 involved a 39-year-old man who was seen at the hospital because of right hypochondralgia and a slight fever. Increases in white blood cell count and level of CRP were noted. CT offered a suspicion of liver abscess, and a hepatic segmentectomy (S5) was performed. Case 2 involved a 43-year-old woman who was seen at the hospital because of right lower abdominal pain. On physical examination, a 10 × 7cm painful tumor was palpated in the ileocecal region. Increases in white blood cell count and CRP level were noted. With colonoscopic fiber, a submucosal tumor of the cecum (malignant lymphoma) was suspected and a right hemicolectomy was performed. Histological studies of the resected materials from both patients revealed specific club formation surrounding the grain. The definitive diagnosis of actinomycosis was made in them. In recent years, abdominal actinomycoses are relatively rare, and among of them primary actinomycosis of the liver is especially so rare that only nine cases have been reported in Japan in the last one decade. It can be said that the case is extremely rare. Although it is rare, we must keep the disease in mind in differential diagnosis of tumorous hepatic lesions including malignant tumors.