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Allergic bronchopulmonary aspergillosis (ABPA)

Case contributed by: Dr Frank Gaillard

Presentation:

Long history of respiratory wheeze and chronic cough.

Patient Data:

Age: 35 years
Gender: Male
Race: Caucasian

Chest x-ray

Modality: X-ray

Chest x-ray demonstrates tubular branching opacities in the right upper lobe. In the left upper lobe a number parallel lines extending from the hilum (tram track) suggest bronchiectasis. 

CT chest

Modality: CT

Single image through the upper zones confirms the presence of bronchiectasis on the left (somewhat movement degraded). On the right many of the dilated bronchi are filled with secretions. 

Annotated images

Modality: Annotated image

"Glove like" opacity in the right upper zone (yellow dotted line) represents sputum plugged bronchiectasis. Air-filled bronchiectasis is seen bilaterally (green arrows). 

Case Discussion:

These films demonstrate characteristic appearances of ABPA. 

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