Fig. 7

Mixed parenchymal, bronchiectatic and mediastinal actinomycosis in a 69-year-old woman with haemoptysis. a Chest CT scan with a modified window setting shows lobar consolidation with cavitary change in the left lower lobe. Note the distended oesophagus with a beak-like appearance that extends toward the consolidation of the left lower lobe (arrow). This lesion was confirmed to be an oesophagobronchial fistula after lobectomy. b Chest CT scan with the mediastinal window setting at the level below (a) shows calcified brocholith (arrowhead) within the dilated tubular mucus retained bronchus. c Left lower lobectomy specimen showed cystic dilation of thickened bronchi, filled with greyish, fragile and granular material with a foul odour. A connection between the oesophagus and bronchus (oesophagobronchial fistula, arrow) was found where the steel rod is pointing (arrow)