Imaging

ABPA

Allergic bronchopulmonary aspergillosis

  • Exaggerated response to aspergillus
  • Most commonly with Asthma or CF
    • Spores are commonly found in soil and even the sputum of healthy individuals
  • Airway inflammation leads to bronchiectasis and, if not treated, it can lead to significant scarring

So, how do we diagnose this disease?

It's not entirely agreed upon

  • Chest X-rays 
  • CT scans
  • IgE and eosinophils
  • Immunological tests for Aspergillus 
    • with staining and sputum cultures 

Treatment, however, is

  • Steroids
  • Antifungal medications

Imaging modalities

  • Chest Xray
  • CT

X-Ray

  • If early, there may be no signs of infection on CXR
  • Classically, there is consolidation and mucoid impaction
  • Some notable signs include
    • Finger-in-glove opacities
    • "Toothpaste shadows"

CT

  • Fleeting alveolar opacities
  • Centrilobular nodules
  • High attenuation in impacted mucous
  • Bronchial wall thickening

Finger in glove

Cylindrical

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