case_images: PMC3573988_01
case_images: Abdominal computed tomography. Contrast-enhanced computed tomography during the arterial phase shows a hypodense lesion (arrows) in the left lobe of the liver, with infiltration to the surrounding tissue.
case_images: 1752-1947-7-31-1.jpg
case_images: PMC3573988_01_1752-1947-7-31-1.jpg
case_images: F1
case_images: Computed tomography of his abdomen confirmed a mass measuring seven cm in diameter in the left lateral segment of his liver (Figure 1).
case_images: Pathological section demonstrating the characteristic sulfur granules. (A) Liver tissue showing sulfur granules surrounded by neutrophils, foaming histiocytes, lymphocytes, and plasma cells (hematoxylin-eosin, x200). (B) Bacterial colonies of Actinomyces tested positive for periodic acid-Schiff with the Splendore-Hoeppli reaction at the periphery and outer zone of the inflammatory cells (x200).
case_images: 1752-1947-7-31-2.jpg
case_images: PMC3573988_01_1752-1947-7-31-2.jpg
case_images: F2
case_images: The colonies tested positive for periodic acid-Schiff with the Splendore-Hoeppli reaction at the periphery and outer zone of inflammatory cells (Figure 2).
case_images: Serum levels of high mobility group box chromosomal protein 1. Serum levels of high mobility group box chromosomal protein 1 were evaluated by enzyme-linked immunosorbent assay. Bars show the means. The high mobility group box chromosomal protein 1 level in the patient with actinomycosis was higher than the control and hepatocellular carcinoma groups, and the serum high mobility group box chromosomal protein 1 levels in the hepatocellular carcinoma group were significantly higher than the control group (5.2+-0.7ng/mL vs. 2.1+-0.9ng/mL; P<0.01). HMGB1, high mobility group box chromosomal protein 1; HCC, hepatocellular carcinoma.
case_images: 1752-1947-7-31-3.jpg
case_images: PMC3573988_01_1752-1947-7-31-3.jpg
case_images: F3
case_images: The HMGB1 level in the patient who had actinomycosis was higher than the control and HCC groups (Figure 3).
case_images: Expression of high mobility group box chromosomal protein 1 in the hepatic tissues. (A) High mobility group box chromosomal protein 1 messenger ribonucleic acid levels were determined by reverse transcriptase polymerase chain reaction. The high mobility group box chromosomal protein 1 messenger ribonucleic acid levels in the affected tissues of the patient with hepatic actinomycosis were significantly higher than those in the control and hepatocellular carcinoma tissues (0.82 vs. 0.15+-0.02 and 0.51+-0.07, respectively). (B) Total protein was extracted from hepatic tissues and high mobility group box chromosomal protein 1 content was detected by western blot. The high mobility group box chromosomal protein 1 content in the affected tissues of the patient with hepatic actinomycosis was significantly higher than that of the control and hepatocellular carcinoma tissues (0.87 versus 0.32+-0.09 and 0.55+-0.07, respectively). HMGB1, high mobility group box chromosomal protein 1; HCC, hepatocellular carcinoma; mRNA, messenger ribonucleic acid; bp, base pairs.
case_images: 1752-1947-7-31-4.jpg
case_images: PMC3573988_01_1752-1947-7-31-4.jpg
case_images: F4
case_images: HMGB1 messenger ribonucleic acid (mRNA) and protein in hepatic tissues was determined by reverse transcriptase polymerase chain reaction and western blot, respectively. HMGB1 mRNA and protein levels were significantly increased in the hepatic actinomycosis tissue compared with the control and HCC tissue (Figure 4).
case_images: Intracellular localization of high mobility group box chromosomal protein 1 in the hepatic tissues. Cells were double-stained with anti-high mobility group box chromosomal protein 1 antibodies and propidium iodide and analyzed by confocal microscopy. In the control cells, high mobility group box chromosomal protein 1 was located in the cytoplasm. In the hepatocellular carcinoma group, high mobility group box chromosomal protein 1 was mainly located in the nucleus. In the actinomycosis-affected cells, a high level of high mobility group box chromosomal protein 1 was found in both the cytoplasm and nucleus (original magnification, x400). HMGB1, high mobility group box chromosomal protein 1; HCC, hepatocellular carcinoma; PI, propidium iodide.
case_images: 1752-1947-7-31-5.jpg
case_images: PMC3573988_01_1752-1947-7-31-5.jpg
case_images: F5
case_images: In the actinomycosis-affected cells, staining in both the cytoplasm and nucleus was enhanced, suggesting increased HMGB1 protein levels throughout the hepatic cell in this patient with primary hepatic actinomycosis (Figure 5).