X-ray
Frontal
What are the two main underlying chronic lung pathologies that predispose to ABPA?
Asthma and cystic fibrosis.
Which laboratory tests are indicated if ABPA is clinically suspected?
1. Aspergillus serology; 2. Total serum IgE level; 3. Peripheral eosinophil count;
What are the classic radiographic features of ABPA?
1. Transient, bilateral alveolar or subsegmental infiltrates with upper lobe predominance; 2. Central ring shadows representing bronchiectasis and bronchial wall thickening; 3. Branching tubular opacities representing mucus plugging, so-called 'finger-in-glove'
What is the treatment for ABPA?
Oral corticosteroids (plus oral antifungals if infection is recurrent/chronic).
There is nodular dense opacification in a finger-in-glove configuration overlying the right hilum and extending into the right upper lobe. This is likely to represent a combination of hilar lymphadenopathy and infective consolidation/bronchial plugging. In addition, there is perihilar consolidation on the left.