Allergic bronchopulmonary aspergillosis

Case contributed by Frank Gaillard
Diagnosis almost certain

Presentation

Long history of respiratory wheeze and chronic cough.

Patient Data

Age: 35 years
Gender: Male

Chest x-ray

x-ray

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

CT chest

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

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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