Korean J Gastroenterol.  2023 Sep;82(3):137-139. 10.4166/kjg.2023.068.

Case of Esophageal Actinomycosis Occurred after Endoscopic Mucosal Resection for Subepithelial Tumor

• Nguyen HT
• Cho JW
• Kim SG
• Hoang TT
• Jung GM
• Cho BJ
• Ju MJ

• KMID: 2546515
• DOI: http://doi.org/10.4166/kjg.2023.068

Abstract

Esophageal actinomycosis is a rare, chronic granulomatous disease caused by Actinomyces species. Endoscopy and biopsy are essential for making a diagnosis. This paper reports a case of esophageal actinomycosis that developed after an endoscopic mucosal resection (EMR) for a subepithelial tumor (SET). A 74-year-old male patient had a 3 cm flat, smooth elevation in the esophagus without symptoms. The SET was partially resected, and histology revealed “nonspecific degenerated mesenchymal tissue”. Three months later, the patient exhibited a persistently large ulceration at the EMR site, and a biopsy revealed actinomycosis. CT of the chest and abdomen revealed no abnormal findings. Ampicillin treatment was administered for six months, and the ulceration on the esophageal SET improved.

Keyword

Esophageal actinomycosis; Endoscopic mucosal resection

Figure

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  Fig. 1 Endoscopic findings. (A) Flat lobulated smooth elevation was noted, (B) EMR was done. (C) Three months later, a large ulcer on the Esophageal SET was seen. (D) The ulcer was improved markedly four months after antibiotic treatment. EMR, endoscopic mucosal resection; SET, subepithelial tumor.

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  Fig. 2 Histopathological findings. (A) Bacterial colony with hematoxyphillic filamentous bacteria was seen (hematoxylin & eosin stain, ×400). (B) The edge of a granule showed filaments (Grocott's methenamine silver stain, ×400).

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