Presentation
Long history of respiratory wheeze and chronic cough.
Patient Data
Chest x-ray demonstrates tubular branching opacities in the right upper lobe. In the left upper lobe a number of parallel lines extending from the hilum (tram track) suggest bronchiectasis.
Single image through the upper zones confirms the presence of bronchiectasis on the left (somewhat movement degraded). On the right many of the dilated bronchi are filled with secretions.
"Glove like" opacity in the right upper zone (yellow dotted line) represents sputum plugged bronchiectasis. Air-filled bronchiectasis is seen bilaterally (green arrows).
Case Discussion
These films demonstrate characteristic appearances of ABPA.