Case of Ray Fungus Presenting with Abdominal Distension
Published: January 1, 2024 | DOI: https://doi.org/10.7860/JCDR/2024/65778.18957
Trisha Sankaran, Gramani Arumugam Vasugi, Raja Senthil, Sandhya Sundaram
1. Postgraduate, Department of Pathology, Sri Ramachandra Institue of Higher Education, Chennai, Tamil Nadu, India.
2. Assistant Professor, Department of Pathology, Sri Ramachandra Institute of Higher Education and Sciences, Chennai, Tamil Nadu, India.
3. Professor, Department of Surgey, Sri Ramachandra Institute of Higher Education and Sciences, Chennai, Tamil Nadu, India.
4. Professor, Department of Pathology, Sri Ramachandra Institue of Higher Education, Chennai, Tamil Nadu, India.
Correspondence
Trisha Sankaran,
H-1, Mohana Alacrity Flats, 96, Arcot Road, Virugambakkam, Chennai-600092, Tamil Nadu, India.
E-mail: trisha_sankaran@yahoo.co.in
Actinomycosis is a rare infection caused by filamentous, non acid fast staining and gram positive bacteria. The diagnosis is rarely made preoperatively, and only histopathological examination can confirm it, as the condition presents with varied clinical manifestations, often resembling a malignant lesion on radiographic images. Hereby, the authors present a case of a 67-year-old female, who was admitted for evaluation of an abdominal mass. Radiologically, the mass resembled a desmoplastic fibroma, and clinically, it was suspected to be the same. The mass was excised and sent for histopathological examination. Grossly, two specimens were received. The first consisted of adherent bowel loops, including the ileum, appendix, caecum and descending colon, with the mass arising from mesentery involving the bowel, measuring 11.5x9.5x6 cm. The second specimen was a partial cystectomy specimen, with the abdominal wall mass infiltrating the bladder anteroposteriorly, measuring 11x10x8 cm. Microscopic examination revealed extensive areas of inflammation with actinomycotic organisms exhibiting the Splendore-Hoeppli phenomenon, along with numerous multinucleated giant cells and acute on chronic inflammatory infiltrate. Surrounding areas showed dense collagen bundles. The prognosis after complete surgical resection is good, along with the administration of broad spectrum intravenous antibiotics.
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