Abstract
A 61-year-old man presented with febrile and productive cough. Laboratory examination showed peripheral eosinophilia and elevated serum IgE concentration. Immediate and late skin reactivity to Aspergillus antigen, and precipitating antibody against Aspergillus antigen were positive. An X-ray film of the chest showed an infiltrative shadow. From these results, this case was diagnosed as an allergic bronchopulmonary aspergillosis. He has never experienced bronchial asthma or dyspnea, and his respiratory threshold of acetylcholine was insignificantly low (10, 000 μg/ml ; normal range>10, 000μg/ml). Therefore it was thought that he did not have typical asthma. An X-ray film of the chest revealed a cavitary lesion in the left lung field. It was difficult to differentiate this case from lesions of the pulmonary tuberculosis or pulmonary suppuration. Histological examination disclosed that the inner wall of the cavity consisted of bronchial wall with eosinophilic infiltration. Thus, it was suggested that the genesis of the cavity was due to bronchiectasis.
