1997 Volume 19 Issue 3 Pages 223-226
A 49-year-old woman with no history of bronchial asthma was admitted to our hospital because of productive cough. Her chest roentgenogram showed a mass in the left lower lung field. Laboratory findings showed peripheral eosinophilia and pulmonary function tests revealed mild obstructive respiratory impairment. CT showed a "gloved finger shadow" transiently. Bronchography with iopamidol revealed cystic bronchiectasis of the 4th and 5th order of bronchi but alveolograms we not obtained. Histological examination by transbronchial biopsy demonstrated bronchocentric granuloma. Positive immediate and late skin reaction to A. fumigatus antigen and precipitating antibodies against A. fumigatus antigen resulted in a diagnosis of allergic bronchopulmonary aspergillus (ABPA). ABPA accompanied by cystic bronchiectasis is rare, and is thought to represent an advanced stage. In this case, cystic lesions were demonstrated on a chest X-ray film taken three years previously. The course of ABPA should be carefully followed even when asymptomatic.
