ABDOMINAL ACTINOMYCOSIS - CT FINDINGS IN 10 PATIENTS

OBJECTIVE. The purpose of this study was to analyze the CT findings in 10 patients with abdominal actinomycosis to determine the appearance of lesions and the pattern of spread of the disease. MATERIALS AND MET HODS. We retrospectively reviewed the CT findings in 10 patients with pathologically proved actinomycosis. Involved areas were the pelvis (n = 4), greater omentum (n = 3), liver (n = 2), and kidney (n = 1). Con trast-enhanced (oral and IV) CT scans were available in all patients. Unenhanced CT scans were also available in six patients. RESULTS. CT s cans showed mostly solid masses with focal areas of diminished attenua tion in seven patients and mostly cystic masses with thickened walls i n three. CT findings confirmed the infiltrative nature of the disease, showing its tendency to invade across tissue planes and boundaries. D ense inhomogeneous contrast enhancement in the walls or solid componen ts of masses was seen in eight patients. Minimal lymphadenopathy was s een in only two patients. CONCLUSION. Although nonspecific, actinomyco sis should be included in the differential diagnosis when CT scans sho w an infiltrative mass with unusual aggressiveness and dense inhomogen eous contrast enhancement, especially in patients with fever, leukocyt osis, or long-term use of intrauterine contraceptive devices.