A Case series of ABPA with rare radiological presentation

Abstract

Allergic bronchopulmonary aspergillosis (ABPA) is an immunologically mediated lung disease that occurs in response to Aspergillus fumigatus which affects primarily asthmatic and cystic fibrosis patients. Central bronchiectasis is a classical radiological presentation of ABPA, but the presentation as total collapse of the lung, pneumothorax, lung mass, or fibrocavitary disease has been rarely described. First case was a 50-year-old nonsmoker male who presented radiologically as complete collapse of left lung. The second case was 54-year-old nonsmoker male presented with breathlessness and chest radiograph showed right-sided pneumothorax which expand after chest tube insertion. The third case a 35-year-old female who treated as bronchial asthma and refer to us for provisional diagnosis of malignancy after saw chest radiograph. The last case was a 22-year-old male who had typical symptoms and radiologically features of pulmonary tuberculosis. All these patients were treated by antitubercular drug, but later, all four case turn out as ABPA. This case series highlights the rare radiological presentation of ABPA (pneumothorax, lung collapse, lung mass, and fibrocavitary), and identifying these diseases in the early stage can prevent the development of end-stage pulmonary fibrosis.