Unexpected radiological presentation in allergic bronchopulmonary aspergillosis: multiple lung masses

We present the case of a 56-year-old woman, which presented to the emergency department with a 2-week history marked by progressive dyspnoea, a productive cough, self-reported wheezing and she had no fever (36.7 °C). The patient had a prior medical history of severe persistent asthma, managed with Mepolizumab, bronchiectasis predominantly in the upper lobes, allergic bronchopulmonary aspergillosis (ABPA) treated in 2016, acquired IgG1 and IgG2 deficiency under regular treatment with intravenous immunoglobulins and a chronic bronchial infection due to pseudomonas aeruginosa. Cystic fibrosis was ruled out in 2015. A sweat test result was 30 mEq/L (normal values up to 40 mEq/L), and a genetic study, which included 54 possible mutations associated with this disease, was also negative. The patient was initially admitted …