“ Usually occurs in the context of chronic asthma or cystic fibrosis. Aspergillus organisms are inhaled by an atopic host and cause a hype...
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Usually occurs in the context of chronic asthma or cystic fibrosis. Aspergillus organisms are inhaled by an atopic host and cause a hypersensitivity reaction. It is the most common pulmonary cause of an eosinophilia. Treatment is with steroids.
• Migratory patchy foci of consolidation.
• ‘Tram track’ appearance (i.e. gross bronchiectasis), central/upper zones is classic.
• Tubular opacities are classic—these are dilated airways plugged with mucous, known as the ‘finger in glove’ appearance.
• Atelectasis from airway obstruction.
HRCT
• Hyperdense mucoid impaction of central and upper lobe airways giving rise to bronchiectasis.
• Bronchiectasis is varicose or saccular.
• Centrilobular nodules and masses are features, not pleural effusions.
• Chronic disease leads to upper zone fibrosis.
• Air-trapping—gives a mosaic pattern of attenuation
Allergic bronchopulmonary aspergillosis. Chest x-ray demonstrating gross central bronchiectasis with tubular opacities. These represent mucous-filled bronchi known as the ‘finger in glove’ appearance.
Allergic bronchopulmonary aspergillosis. CT image demonstrating gross central varicose bronchiectasis (white arrow) with mucous-filled bronchi.
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