Clinical Image
Endobronchial Mass as a Debut Form of Actinomycosis
Tina Herrero Jordán
, María Betrán Orduna, Itziar Campo Esnaola
Corresponding author
Department of Pneumology, Hospital Reina Sofía, Tudela, Navarra, Spain
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Quantification of Sirius Red stained collagen in TGF-β1 primed cells. Data represents fold changes relative to non TGF-β1 primed cells (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3). (B) Cell viability measured after 0, 72 and 144<span class="elsevierStyleHsp" style=""></span>h of EVs treatment in TGF-β1 primed cells. Data represents fold changes relative to non EVs treated cells at each time point (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3). (C) LDH activity released to cell culture media after 0, 72 and 144<span class="elsevierStyleHsp" style=""></span>h of EVs treatment in TGF-β1 primed cells. 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(E) Proteomic analysis of 483 total and phosphorylated proteins were analysed by reverse phase protein array (RPPA) of IPF-MSCs from the same patient under 4 conditions: non treated L-MSCs, non TGF-β1 primed L-MSCs<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>12<span class="elsevierStyleHsp" style=""></span>μg/ml EVs, TGF-β primed L-MSCs without EVs treatment and TGF-β1 primed L-MSCs<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>12<span class="elsevierStyleHsp" style=""></span>μg/ml EVs, Venn diagram showing differentially expressed (over 0.3 Log<span class="elsevierStyleSup">2</span> median-centered) proteins between groups. (F) Representative confocal images of cells stained for LC3-B in green (FITC), actin in red (Phalloidin-Texas red) and nuclei in blue (DAPI). (G) Graphical representation of annexin V and propidium iodide positive cells at 72<span class="elsevierStyleHsp" style=""></span>h of EVs treatment (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3).</p> <p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Bar graphs represent the mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>S.D. 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"apellidos" => "Ramis" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289623000200?idApp=UINPBA00003Z" "url" => "/03002896/0000005900000007/v3_202310232131/S0300289623000200/v3_202310232131/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0300289623001667" "issn" => "03002896" "doi" => "10.1016/j.arbres.2023.05.008" "estado" => "S300" "fechaPublicacion" => "2023-07-01" "aid" => "3322" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2023;59:452" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "An Unusual Case of Pulmonary Amyloidosis Causing Pleural Effusion Diagnosed With Medical Thoracoscopy" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "452" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1248 "Ancho" => 1667 "Tamanyo" => 308940 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Chest X-ray showing moderate to large right sided pleural effusion. 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The patient presented with progressive dyspnea, intense asthenia and loss of 10<span class="elsevierStyleHsp" style=""></span>kg of weight in less than three months. Chest X-ray and computed tomography both showed an obstructive lesion at the left upper lobe bronchus suggestive of endobronchial neoplasia. Positron emission tomography (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, A) showed increased uptake of 18F-fluorodeoxyglucose from the lesion (SUV<span class="elsevierStyleInf">máx</span> 12.6). Flexible bronchoscopy revealed an endobronchial lesion that obstructed the entire left upper bronchus (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, B) biopsies of said lesion showed abundant Actynomices colonies.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Actinomycosis is a bacterial infection caused by microorganisms of the genus Actynomices. Lung involvement is very rare, being the most frequent presentation the mandibular abscess.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> For its diagnosis, microbiological or anatomopathological identification of the microorganism is necessary. The treatment of choice is Penicillin between 6 and 12 months.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1,2</span></a></p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0020" class="elsevierStylePara elsevierViewall">There was no funding source in this study.</p></span><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interest</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest to the publication of this article.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interest" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 453 "Ancho" => 1005 "Tamanyo" => 49369 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) hypemetabolic consolidation occupying the entire left upper lobe with obstruction of the upper lobe bronchus close to the bifurcation of the main bronchus; (B) flexible bronchoscopy shows an endobronchial lesion obstructing the left upper bronchus entrance (arrow).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary actinomycosis during the first decade of 21st century: cases of 94 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.R. Kim" 1 => "L.Y. Jung" 2 => "I.J. Oh" 3 => "Y.C. Kim" 4 => "K.C. Shin" 5 => "M.K. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1471-2334-13-216" "Revista" => array:5 [ "tituloSerie" => "BMC Infect Dis" "fecha" => "2013" "volumen" => "13" "paginaInicial" => "216" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23672372" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary actinomycosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "G.F. Mabeza" 1 => "J. Macfarlane" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.03.00089103" "Revista" => array:7 [ "tituloSerie" => "Eur Respir J" "fecha" => "2003" "volumen" => "21" "paginaInicial" => "545" "paginaFinal" => "551" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12662015" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0140673612601494" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03002896/0000005900000007/v3_202310232131/S0300289623001680/v3_202310232131/en/main.assets" "Apartado" => array:4 [ "identificador" => "94561" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Clinical Images" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005900000007/v3_202310232131/S0300289623001680/v3_202310232131/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289623001680?idApp=UINPBA00003Z" ]
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