Fig. 6
Co-infection of bronchiectatic actinomycosis with Aspergillus in a 52-year-old man. Chest CT scan in lung window setting obtained with an axial scan (a) and a coronal reformatted image (b) shows focal bronchiectatic changes with intraluminal nodules in the right upper lobe. The presumptive diagnosis was aspergilloma within bronchiectasis. Low-power photomicrography of the surgical specimen from the right upper lobe (c) (original magnification, ×20; haematoxylin-eosin stain) demonstrates an Actinomyces colony (star) within the ectatic bronchus (arrows). Medium-power photomicrograph (d) (original magnification, ×400; Gomori methenamine-silver stain) shows a nodule within bronchiectasis composed of central aggregation of Aspergillus (arrow) and surrounding Actinomyces colonies (star)