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Overlapping lung parenchymal and bronchial lesion and hilar lymphadenopathy in pulmonary actinomycosis mimicking lung cancer

A 43-year-old man with a 9-year history of schizophrenia presented with productive cough, and was diagnosed with pneumonia of the left lung. As treatment with clarithromycin followed by garenoxacin was not effective, the patient was referred to our hospital. Although physical examination was unremarkable, chest X-ray and enhanced CT showed an irregular-shaped mass in the left inferior lobe, with airway stenosis of the lobar bronchus due to wall thickness and hilar lymphadenopathy (figure 1A–C). The bronchoscopic view of swollen mucosa with nodules was compatible with lung cancer mucosal invasion (figure …