{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T00:07:27Z","timestamp":1758931647095,"version":"3.44.0"},"reference-count":43,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["IJMS"],"abstract":"<jats:p>Hepatic actinomycosis (HA) and IgG4-related inflammatory pseudotumors are rare and often overlooked causes of liver mass, which can easily be misdiagnosed as primary liver cancer or metastasis. Diagnosis is arduous due to unspecified clinical and radiological features and the fact that histology is not always conclusive. In cases of actinomycosis, the use of molecular diagnostic techniques\u2014such as polymerase chain reaction (PCR) for bacterial DNA\u2014can aid in establishing a definitive diagnosis, especially when conventional cultures are non-diagnostic. We present a case report of one of our patients who was incidentally diagnosed with a hepatic lesion presenting aspecific radiological features. Since radiological imaging was inconclusive, a biopsy was performed, and a diagnosis of IgG4 related hepatic inflammatory pseudotumor was then made. Because of the disease progression, during immunosuppressive therapy, our diagnosis was questioned and a new liver biopsy was carried out. At the end, it took three consequent biopsies to finally find out the presence of an actinomyces infection.<\/jats:p>","DOI":"10.3390\/ijms26199420","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T11:28:32Z","timestamp":1758886112000},"page":"9420","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Concomitant Autoimmune Liver Disease and Hepatic Actinomycosis: A Diagnostic Challenge\u2014Brief Report and Review of the Literature"],"prefix":"10.3390","volume":"26","author":[{"given":"Giulia","family":"Manni","sequence":"first","affiliation":[{"name":"Gastroenterology Unit, University of Modena & Reggio Emilia, 41124 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Pambianco","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, University of Modena & Reggio Emilia, 41124 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Sicuro","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, University of Modena & Reggio Emilia, 41124 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica","family":"Franceschini","sequence":"additional","affiliation":[{"name":"Infectious Disease Clinic, AOU Modena, 41124 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8271-846X","authenticated-orcid":false,"given":"Alessandra","family":"Pivetti","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, AOU Modena, 41124 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8994-8791","authenticated-orcid":false,"given":"Laura","family":"Bertoni","sequence":"additional","affiliation":[{"name":"Department of Surgery, Medicine Dentistry and Morphological Sciences with Interest in Transplant, 41124 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronica","family":"Bernabucci","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, AOU Modena, 41124 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4615-3777","authenticated-orcid":false,"given":"Marcello","family":"Bianchini","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, AOU Modena, 41124 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Lei","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, AOU Modena, 41124 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Ravaioli","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, AOU Modena, 41124 Modena, Italy"},{"name":"Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8384-801X","authenticated-orcid":false,"given":"Antonio","family":"Colecchia","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, University of Modena & Reggio Emilia, 41124 Modena, Italy"},{"name":"Gastroenterology Unit, AOU Modena, 41124 Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1097\/SMJ.0b013e3181864c1f","article-title":"Actinomycosis: Diagnosis and Management","volume":"101","author":"Brook","year":"2008","journal-title":"South. 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