Foreign body-induced bronchial actinomycosis with severe stenosis that must be distinguished from lung cancer

A 59-year-old woman who accidentally swallowed a foreign body (fish bone) 9 months ago was admitted to our hospital because of cough, hemosputum and sleep wheezing for two months. Chest roentgenograms and chest CT scanning revealed severe stenosis of the right lower lobe bronchus and truncus intermedius, suggesting lung cancer. Bronchoscopic examination revealed an intrabronchial foreign body. The biopsy specimen from granulation tissue revealed bronchial actinomycosis. The foreign body was removed bronchoscopically after an extensive chemotherapy with penicillin G (for actinomycosis) and prednisolone (for granulation tissue of the bronchus). This was considered to be a rare case of bronchial actinomycosis without a pulmonary lesion produced by a foreign body.