Pulmonary inflammatory myofibroblastic tumor encompasses a heterogeneous spectrum of reactive, infectious, and neoplastic entities. It is composed of spindle-shaped myofibroblastic cells in a background of inflammatory cells and collagen fibres. Actinomycosis is a bacterial infection. It infects the lower respiratory tracts by inhalation or aspiration of oropharyngeal or upper gastrointestinal materials. Only eight cases of pulmonary IMT associated with actinomycosis have been reported in the literature so far. This is the ninth case reported.
A 64-year-old man with a history of gallstones, common bile duct stones, chronic hepatitis B virus infection, and hepatic cirrhosis with a Child-Pugh score B was satisfactorily treated for hepatocellular carcinoma with radiofrequency ablation and transarterial chemoembolization. His course, however, was complicated by gallbladder actinomycosis 14 months after treatment, resulting in acute cholecystitis. Such a chain of events suggests that gallbladder actinomycosis may develop after radiofrequency ablation and transarterial chemoembolization in patients who are known to have gallstones and that asymptomatic gallstones should be treated before the application of nonsurgical, but invasive procedures for hepatocellular carcinoma.
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